Jason H Kirkpatrick, LPC
Individual provider Active NPI Professional Counselor · Weldon Spring, MO
NPI 1013230853 · NPPES record last updated Feb 16, 2016
Key facts
- NPI
- 1013230853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2006013032 (MO)
- Practice address
- 4801 Weldon Spring Pkwy
Suite 300
Weldon Spring, MO 63304-9101 - Phone
- (636) 474-9164
- Fax
- (636) 949-0729
- NPI assigned
- Mar 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nystrom Counseling Mo PC
Practice addresses (Care Compare)
801 S Woodlawn Ave
Suite 16
O Fallon, MO 63366-7647
Phone (636) 379-1779
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231117002687 | MO | Practitioner - Mental Health Counselor | 2668820366 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006013032 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom Counseling Mo, PC | Current |
Accepting new patients | |
| St. Charles Psychiatric Associates, Inc. | Past |
Accepting new patients |
Locations
1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2006013032 | MO | Yes |
Addresses
Primary practice location
4801 Weldon Spring Pkwy
Suite 300
Weldon Spring, MO 63304-9101
Mailing address
4801 Weldon Spring Pkwy
Suite 300
Weldon Spring, MO 63304-9101
Phone (636) 474-9164
Other providers in Weldon Spring, MO
- Jennifer Johnston
- Carol Lynn Jones
- Amanda Maria Kearney
- Sara M Kemp
- Mehreen Belal Khann
- Kohlbrecher Mobility LLC
- Kimberly Christen Koors
- Spencer Kronauge
- Sara Jane Krone
- Despina (Penny) Angela Kyramarios
All providers in Weldon Spring, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.