Individual provider Active NPI

Mirranda Cardinali

  • Professional Counselor
  • Fenton, MO
National Provider Identifier
1124503271
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2018006449 Issued in MO
Practice address
1736 Westpark Ctr Dr Ste 100
Fenton, MO 63026-1916
Phone
(636) 600-0446
Fax
(636) 660-2262
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X 2018006449 MO
Professional Counselor 101YP2500X 2018006449 MO Primary

Addresses

Primary practice location

1736 Westpark Ctr Dr Ste 100
Fenton, MO 63026-1916

Mailing address

1736 Westpark Ctr Dr Ste 100
Fenton, MO 63026-1916
Phone (636) 600-0446

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
I20251114000554 MO Practitioner - Mental Health Counselor 3779074034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1736 Westpark Ctr Dr
Suite 100
Fenton, MO 63026-1916
Phone (636) 600-0446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018006449MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Osage Valley Counseling LLC Professional CurrentSince Sep 20, 2025 Accepting new patients

Locations

1736 W Park Center Dr
Ste 100
Fenton, MO 63026
Phone (636) 600-0446

320 Gravois Rd
Ste 210
Fenton, MO 63026
Phone (314) 467-0373

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": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1124503271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 WESTPARK CTR DR STE 100",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630261916",
            "telephone_number": "636-600-0446",
            "fax_number": "636-660-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 WESTPARK CTR DR STE 100",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630261916",
            "telephone_number": "636-600-0446",
            "fax_number": "636-660-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDINALI",
        "first_name": "MIRRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "MO",
            "license": "2018006449",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2018006449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.