Individual provider Active NPI

Sarah Mohamed Al-Zadjali, MA, LPC

  • Mental Health Counselor
  • Saint Louis, MO
National Provider Identifier
1104505056
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2020036302 Issued in MO
Practice address
967 Gardenview Office Pkwy
Saint Louis, MO 63141-5917
Phone
(314) 561-9757
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2020036302 MO Primary

Addresses

Primary practice location

967 Gardenview Office Pkwy
Saint Louis, MO 63141-5917

Mailing address

10816 Arnett Dr
Saint Louis, MO 63123-7114
Phone (314) 717-9251

Other practice location 1

12818 Tesson Ferry Rd Ste 103
Saint Louis, MO 63128-2945
Phone (314) 923-4655

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
I20240611004534 MO Practitioner - Mental Health Counselor 0941742472 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2020036302MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Mindfulness and CBT, LLC CurrentSince Sep 30, 2023 Accepting new patients
Mypathtoself Inc. Mental Health CurrentSince Apr 29, 2024 Accepting new patients
The Center for Mindfulness and CBT, LLC PastSince Jul 23, 2023 Accepting new patients

Locations

12818 Tesson Ferry Rd
Ste 103
Saint Louis, MO 63128
Phone (314) 912-4655

967 Gardenview Office Pkwy
Saint Louis, MO 63141
Phone (314) 561-9757

2464 Taylor Rd
Wildwood, MO 63040

Organizations & group practices 3

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1104505056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10816 ARNETT DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237114",
            "telephone_number": "314-717-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 GARDENVIEW OFFICE PKWY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415917",
            "telephone_number": "314-561-9757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12818 Tesson Ferry Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282945",
            "country_code": "US",
            "telephone_number": "314-923-4655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-ZADJALI",
        "first_name": "SARAH",
        "middle_name": "MOHAMED",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2020036302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.