NPIMap

Organization Active NPI

Epir Source Mental Health Services

  • Mental Health Counselor
  • Saint Louis, MO
National Provider Identifier
1073374989
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
EPIR SOURCE MENTAL HEALTH SERVICES
Practice address
911 Washington Ave Ste 501
Saint Louis, MO 63101-1272
Phone
(314) 485-9241
Fax
(314) 255-2501
NPI assigned
Jan 18, 2024
Organization subpart
Yes
Parent organization
EPIR SOURCE MENTAL HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Latrece Marlene Smith, LCSWNPI 1568008282
Title
Owner/Operator
Phone
(314) 485-9241

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

911 Washington Ave Ste 501
Saint Louis, MO 63101-1272

Mailing address

819 Avondale Dr
Saint Peters, MO 63376-7835
Phone (314) 485-9241

Other identifiers 3

IdentifierTypeStateIssuer
1003433202OtherNPI
1912594664OtherNPI
1629686381OtherNPI

Other names 1

  • EPIR Source LLC Other name

National Provider Directory

National Provider Directory
Part of
Epir Source Mental Health Services

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1073374989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 AVONDALE DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767835",
            "telephone_number": "314-485-9241",
            "fax_number": "314-255-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 WASHINGTON AVE STE 501",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011272",
            "telephone_number": "314-485-9241",
            "fax_number": "314-255-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIR SOURCE MENTAL HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EPIR SOURCE MENTAL HEALTH SERVICES",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LATRECE",
        "authorized_official_middle_name": "MARLENE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "314-485-9241",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003433202",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912594664",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629686381",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EPIR Source LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 18, 2024; 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.