Provident

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

License

2002014019 Issued in MO

Legal business name

PROVIDENT

Practice address

3675 W Outer Rd Ste 203
Arnold, MO 63010-5232

Phone

(314) 898-0102

Fax

(636) 296-3249

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Maria M Watkins, LPC

Title

Counselor

Phone

(314) 898-0102

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104924745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 W OUTER RD STE 203",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630105232",
            "telephone_number": "314-898-0102",
            "fax_number": "636-296-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 W OUTER RD STE 203",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630105232",
            "telephone_number": "314-898-0102",
            "fax_number": "636-296-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "314-898-0102",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "MO",
            "license": "2002014019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Voluntary or Charitable Agency in Arnold, MO
• Providers in Arnold, MO by specialty
• Voluntary or Charitable Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.