NPIMap

Organization Active NPI

LDS Family Services

Doing business as LDS Family Services MO Bridgeton

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeton, MO
National Provider Identifier
1174625388
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
2002002940 Issued in MO
Legal business name
LDS FAMILY SERVICES
Doing business as
LDS Family Services MO Bridgeton
Practice address
12843 Pennridge Dr
Bridgeton, MO 63044-1238
Phone
(314) 344-0048
Fax
(314) 344-0057
NPI assigned
Sep 1, 2006
Last updated
Jun 6, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
LDS FAMILY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Mr. Paul R. Gale, LCSWNPI 1689898512
Title
Agency Director
Phone
(816) 461-5512

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2002002940 MO Primary

Addresses

Primary practice location

12843 Pennridge Dr
Bridgeton, MO 63044-1238

Mailing address

12843 Pennridge Dr
Bridgeton, MO 63044-1238
Phone (314) 344-0048

Other names 1

  • LDS Family Services MO Bridgeton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
LDS Family Services46 organizations share this tax ID, including this one
Part of
LDS Family Services

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Locations

12843 Pennridge Dr
Bridgeton, MO 63044
Phone (314) 344-0048

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1174625388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12843 PENNRIDGE DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441238",
            "telephone_number": "314-344-0048",
            "fax_number": "314-344-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12843 PENNRIDGE DR",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441238",
            "telephone_number": "314-344-0048",
            "fax_number": "314-344-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDS FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LDS FAMILY SERVICES",
        "enumeration_date": "2006-09-01",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "GALE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "AGENCY DIRECTOR",
        "authorized_official_telephone_number": "816-461-5512",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MO",
            "license": "2002002940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDS Family Services MO Bridgeton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.