Individual provider Active NPI

Nathan W Staley, MA LPC

  • Professional Counselor
  • Parkville, MO
National Provider Identifier
1063871218
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2016001689 Issued in MO
Practice address
819 Main St
Parkville, MO 64152-3630
Phone
(816) 607-1713
NPI assigned
Feb 16, 2016
Last updated
Apr 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2016001689 MO Primary

Addresses

Primary practice location

819 Main St
Parkville, MO 64152-3630

Mailing address

819 Main St
Parkville, MO 64152-3630
Phone (816) 607-1713

Other practice location 1

851 NW 45th St Ste 104
Kansas City, MO 64116-4613
Phone (816) 607-1713

Other practice location 2

314 Armour Rd
North Kansas City, MO 64116-3506
Phone (816) 607-1713

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2016001689MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Cognition LLC Professional CurrentSince May 29, 2022 Accepting new patients
Asap Expert Counseling Past Accepting new patients

Locations

819 Main St
Parkville, MO 64152
Phone (816) 607-1713

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1063871218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 MAIN ST",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "641523630",
            "telephone_number": "816-607-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 MAIN ST",
            "city": "PARKVILLE",
            "state": "MO",
            "postal_code": "641523630",
            "telephone_number": "816-607-1713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 NW 45th St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641164613",
            "country_code": "US",
            "telephone_number": "816-607-1713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "314 Armour Rd",
            "address_purpose": "LOCATION",
            "city": "North Kansas City",
            "state": "MO",
            "postal_code": "641163506",
            "country_code": "US",
            "telephone_number": "816-607-1713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALEY",
        "first_name": "NATHAN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "MA LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-16",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2016001689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.