Organization Active NPI

Depression Clinic at the Health Centers

  • Psychiatry Physician
  • Saint Charles, MO
National Provider Identifier
1093430944
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DEPRESSION CLINIC AT THE HEALTH CENTERS
Practice address
2621 Raymond Dr
Saint Charles, MO 63301-4872
Phone
(636) 946-2244
Fax
(636) 946-6975
NPI assigned
Oct 4, 2022
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Miss Kayla C Brooks, M.A, EMT-B, CTMS
Title
Director
Phone
(636) 946-2244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2621 Raymond Dr
Saint Charles, MO 63301-4872

Mailing address

2621 Raymond Dr
Saint Charles, MO 63301-4872
Phone (636) 946-2244

Other identifiers 1

IdentifierTypeStateIssuer
203861919MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ins_dept@thehealthcenters.com THE HEALTH CENTERS, P.C.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230131001427 MO Part B Supplier - Clinic/Group Practice 9032580030 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Charles, MO

National Provider Directory

National Provider Directory

Locations

2621 Raymond Dr
Ste 1
Saint Charles, MO 63301
Phone (636) 946-2244

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1093430944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 RAYMOND DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014872",
            "telephone_number": "636-946-2244",
            "fax_number": "636-946-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 RAYMOND DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633014872",
            "telephone_number": "636-946-2244",
            "fax_number": "636-946-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPRESSION CLINIC AT THE HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "636-946-2244",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "M.A, EMT-B, CTMS"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203861919",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ins_dept@thehealthcenters.com",
            "affiliation": "Y",
            "affiliationName": "THE HEALTH CENTERS, P.C.",
            "address_1": "2621 Raymond Dr",
            "city": "Saint Charles",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633014872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.