Jennifer Kinsella, MA, LPC

Individual provider Active NPI Professional Counselor · Saint Peters, MO

NPI 1124431473 · NPPES record last updated Jun 4, 2014

Key facts

NPI
1124431473
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2012018462 (MO)
Practice address
1600 Heritage LNDG
116
Saint Peters, MO 63303-8489
Phone
(636) 345-1400
Fax
(636) 441-3262
NPI assigned
Jun 4, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2012018462MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dragonfly Wellness, LLC Professional Past
since Jun 5, 2022
Accepting new patients
Collaborative Counseling, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2012018462 MO Yes

Addresses

Primary practice location

1600 Heritage LNDG
116
Saint Peters, MO 63303-8489

Mailing address

1600 Heritage LNDG
116
Saint Peters, MO 63303-8489
Phone (636) 345-1400

Other providers in Saint Peters, MO

All providers in Saint Peters, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.