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

Mr. Deangelo Leon Mardis Jr.

Individual provider Clinical Social Worker · NPI 1104687219

Mr. Deangelo Leon Mardis Jr. is a Clinical Social Worker in Saint Louis, Missouri. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone: (314) 206-3700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1104687219
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 17, 2024
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 17, 2024

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