NPIMap

Organization Active NPI

Serendipity Counseling Saint Louis

  • Professional Counselor
  • O Fallon, MO
National Provider Identifier
1114738051
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SERENDIPITY COUNSELING SAINT LOUIS
Practice address
1001 Boardwalk Springs PL Ste 111
O Fallon, MO 63368-4777
Phone
(636) 352-4324
NPI assigned
Jan 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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

Authorized official

Name
Kimberly Lynn Roberts, MS, LPCNPI 1750920922
Title
Owner/LPC
Phone
(636) 290-8147

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1001 Boardwalk Springs PL Ste 111
O Fallon, MO 63368-4777

Mailing address

68 Shirley Dr
Troy, MO 63379-6304
Phone (636) 290-8147

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737331200000",
    "number": "1114738051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 SHIRLEY DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633796304",
            "telephone_number": "636-290-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BOARDWALK SPRINGS PL STE 111",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633684777",
            "telephone_number": "636-352-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIPITY COUNSELING SAINT LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-19",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/LPC",
        "authorized_official_telephone_number": "636-290-8147",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.