St. John'S Mercy Health Services, LLC

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

Legal business name

ST. JOHN'S MERCY HEALTH SERVICES, LLC

Practice address

1000 Des Peres Rd
Suite 200C
Saint Louis, MO 63131-2050

Phone

(314) 729-4639

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Scott Frederick, PH.D

Title

Director

Phone

(314) 729-4639

Specialties & licenses 4

Addresses

Other names 1

• St. John's Mercy Managed Behavioral Health Doing business as

Tax ID family

Sleep Medicine and Research5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Lincoln County Memorial Hospital

  • Home Health Agency
  • Troy, MO
  • NPI 1073521910
  NPD tax ID
• Mercy Health Services LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1154407112
  NPD tax ID
• Mercy Health Services, LLC

  • Pharmacy
  • Washington, MO
  • NPI 1255781241
  NPD tax ID
• St Johns Mercy Health Services LLC

  • Eyewear Supplier
  • Saint Louis, MO
  • NPI 1467597195
  NPD tax ID

Locations

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1053458299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DES PERES RD",
            "address_2": "SUITE 200C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312050",
            "telephone_number": "314-729-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DES PERES RD",
            "address_2": "SUITE 200C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312050",
            "telephone_number": "314-729-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S MERCY HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-729-4639",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. John's Mercy Managed Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction (Substance Use Disorder) Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Addiction (Substance Use Disorder) Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.