NPIMap

Organization Active NPI

The Center for Mindfulness and CBT, LLC

  • Cognitive & Behavioral Psychologist
  • Saint Louis, MO
National Provider Identifier
1013267392
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
2006027463 Issued in MO
Legal business name
THE CENTER FOR MINDFULNESS AND CBT, LLC
Practice address
10845 Olive Blvd.
Suite 150
St. Louis, MO 63141
Phone
(314) 561-9757
Fax
(314) 561-9050
NPI assigned
Sep 14, 2012
Last updated
Mar 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Laura Chackes, PSY.D
Title
President
Phone
(314) 561-9757

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 2006027463 MO Primary

Addresses

Primary practice location

10845 Olive Blvd.
Suite 150
St. Louis, MO 63141

Mailing address

10845 Olive Blvd.
Suite 150
St. Louis, MO 63141
Phone (314) 561-9757

Other names 1

  • Laura Chackes PSY D LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170215002401 MO Part B Supplier - Clinic/Group Practice 9032492111 Receives reassigned benefits from 11 practitioners
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory
Tax ID family
Laura Chackes Psy D LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

967 Gardenview Office Pkwy
Saint Louis, MO 63141
Phone (314) 561-9757

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1013267392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 OLIVE BLVD.",
            "address_2": "SUITE 150",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-561-9757",
            "fax_number": "314-561-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10845 OLIVE BLVD.",
            "address_2": "SUITE 150",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63141",
            "telephone_number": "314-561-9757",
            "fax_number": "314-561-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CENTER FOR MINDFULNESS AND CBT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-14",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "CHACKES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-561-9757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MO",
            "license": "2006027463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laura Chackes PSY D LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.