Active NPI
Gwendolyn Solomon, LPC
- Professional Counselor
- Saint Louis, MO
National Provider Identifier
1063624005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002589
- Practice address
- 528 Thurston Ave
Saint Louis, MO 63134-1550 - Phone
- (314) 830-4533
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002589 | MO | Primary |
Addresses
Primary practice location
528 Thurston Ave
Saint Louis, MO 63134-1550
Mailing address
528 Thurston Ave
Saint Louis, MO 63134-1550
Phone (314) 830-4533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002589 | MO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1063624005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 THURSTON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631341550",
"telephone_number": "314-830-4533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 THURSTON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631341550",
"telephone_number": "314-830-4533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLOMON",
"first_name": "GWENDOLYN",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "002589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.