Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Emory Madalyn Endicott, LCSW

Individual provider Social Worker · NPI 1376276774

Emory Madalyn Endicott, LCSW is a Clinical Social Worker in Saint Louis, Missouri. Qualified in 2022, 4 years ago. Practices with Provident Inc, a 19-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2022
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

12141 Ladue Rd
Saint Louis, MO 63141
Phone: (314) 898-0100
Fax: (314) 993-2828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2024037830 (MO)
Social Worker Taxonomy 104100000X · Licence 2022020464 (MO)

Record details

NPI number1376276774
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJuly 5, 2022
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Provident Inc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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