Ellen Marting Jayaprabhu, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2006030663 Issued in MO

Practice address

425 N New Ballas Rd Ste 285
Saint Louis, MO 63141-6877

Phone

(314) 635-6505

NPI assigned

Nov 11, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Ellen Anderson Marting Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 24, 2024 through Jan 24, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1033280144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6362 ALAMO AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053104",
            "telephone_number": "314-583-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N NEW BALLAS RD STE 285",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416877",
            "telephone_number": "314-635-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAYAPRABHU",
        "first_name": "ELLEN",
        "middle_name": "MARTING",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2006030663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "MARTING",
            "middle_name": "ANDERSON",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Marriage & Family Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.