International Mosaic Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

INTERNATIONAL MOSAIC THERAPY

Practice address

225 S Meramec Ave Ste 203
Saint Louis, MO 63105-3511

Phone

(314) 492-6296

NPI assigned

Mar 13, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Yuima Mizutani, M.ED., NCC, LPCNPI 1841771748

Title

Owner

Phone

(314) 498-4449

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Yuima Mizutani, M.ED., NCC, LPC

  • Professional Counselor
  • Saint Louis, MO
  • NPI 1841771748
  NPD (past) Authorized official

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1023577749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 PERSHING AVE APT 405",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631121791",
            "telephone_number": "314-498-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE STE 203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053511",
            "telephone_number": "314-492-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL MOSAIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "MIZUTANI",
        "authorized_official_first_name": "YUIMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-498-4449",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841771748",
            "state": "MO"
        }
    ],
    "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 Mar 13, 2019; 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.