Individual provider Active NPI

Stephanie Weatherspoon, LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1073046850
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2017009201 Issued in MO
Practice address
11102 Lindbergh Business CT
Saint Louis, MO 63123-7810
Phone
(314) 206-3400
NPI assigned
Apr 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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 2017009201 MO Primary

Addresses

Primary practice location

11102 Lindbergh Business CT
Saint Louis, MO 63123-7810

Mailing address

1430 Olive St Ste 400
Saint Louis, MO 63103-2303
Phone (314) 206-3700

Other identifiers 1

IdentifierTypeStateIssuer
2017009201OtherMOLPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240213003862 MO Practitioner - Mental Health Counselor 2365886769 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BJC Behavioral HealthGroup PAC ID 1153225271, shared by 2 NPIs, 63 clinicians

Practice addresses (Care Compare)

1085 Maple St
Farmington, MO 63640-1955
Phone (573) 756-5353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017009201MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
BJC Behavioral Health CurrentSince Jan 1, 2024 Accepting new patients
BJC Behavioral Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1085 Maple St
Farmington, MO 63640
Phone (573) 756-5353

1430 Olive St
Ste 400
Saint Louis, MO 63103

11102 Lindbergh Ct
Saint Louis, MO 63123
Phone (314) 206-3400

3309 S Kingshighway Blvd
Saint Louis, MO 63139
Phone (314) 534-9350

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1073046850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032303",
            "telephone_number": "314-206-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11102 LINDBERGH BUSINESS CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237810",
            "telephone_number": "314-206-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEATHERSPOON",
        "first_name": "STEPHANIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017009201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "2017009201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.