Individual provider Active NPI

Kiel Newman, LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1114692357
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2019029436 Issued in MO
Practice address
2055 Craigshire Rd Ste 407C
Saint Louis, MO 63146-4012
Phone
(314) 413-3103
NPI assigned
Aug 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2019029436 MO Primary

Addresses

Primary practice location

2055 Craigshire Rd Ste 407C
Saint Louis, MO 63146-4012

Mailing address

11550 Wickshire CT
Bridgeton, MO 63044-3004
Phone (314) 413-3103

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019029436MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Enrich Your Mind Counseling Professional CurrentSince Jun 17, 2021 Accepting new patients

Locations

15480 Clayton Rd
Ste 302
Ballwin, MO 63011
Phone (314) 384-2528

Organizations & group practices 1

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": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1114692357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11550 WICKSHIRE CT",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630443004",
            "telephone_number": "314-413-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 CRAIGSHIRE RD STE 407C",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464012",
            "telephone_number": "314-413-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "KIEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2019029436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 16, 2021; 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.