Individual provider Active NPI

Brian Glen Storey, D.MIN.

  • Professional Counselor
  • Glen Carbon, IL
National Provider Identifier
1073706248
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
7 Junction Dr
Ste. B
Glen Carbon, IL 62034-4300
Phone
(618) 659-1606
Fax
(314) 835-1016
NPI assigned
Aug 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X 3755 IL
Pastoral Counselor 101YP1600X 3755 MO
Marriage & Family Therapist 106H00000X 300086 MO
Professional Counselor 101YP2500X IL Primary

Addresses

Primary practice location

7 Junction Dr
Ste. B
Glen Carbon, IL 62034-4300

Mailing address

518 Oak Valley Dr
Saint Louis, MO 63131-4730
Phone (314) 580-7233

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

LicenseStateTypeSpecialty
3755ILMDPastoral Counselor
3755MOMDPastoral Counselor
180000325ILMDProfessional Counselor
300086MOMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1073706248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 OAK VALLEY DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314730",
            "telephone_number": "314-580-7233",
            "fax_number": "314-835-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 JUNCTION DR",
            "address_2": "STE. B",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620344300",
            "telephone_number": "618-659-1606",
            "fax_number": "314-835-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOREY",
        "first_name": "BRIAN",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "D.MIN.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "IL",
            "license": "3755",
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "MO",
            "license": "3755",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "300086",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.

Verify at the official NPI Registry.