Kayla Noelle Theberge, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2021046281 Issued in MO

Practice address

10024 Office Center Ave Ste 100
Saint Louis, MO 63128-1392

Phone

(314) 729-7050

NPI assigned

Dec 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1013676865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120",
            "telephone_number": "636-246-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10024 OFFICE CENTER AVE STE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281392",
            "telephone_number": "314-729-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEBERGE",
        "first_name": "KAYLA",
        "middle_name": "NOELLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2021046281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.