Active NPI
Jordan Holbrook
- Professional Counselor
- Saint Louis, MO
National Provider Identifier
1194352500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2018045606
- Practice address
- 222 S Meramec Ave Ste 303
Saint Louis, MO 63105-3514 - Phone
- (423) 298-8653
- NPI assigned
- Mar 25, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2018045606 | MO | Primary |
Addresses
Primary practice location
222 S Meramec Ave Ste 303
Saint Louis, MO 63105-3514
Mailing address
15041 Baxter Village Dr Apt D
Chesterfield, MO 63017-7873
Phone (423) 298-8653
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018045606 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585094400000",
"number": "1194352500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15041 BAXTER VILLAGE DR APT D",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630177873",
"telephone_number": "423-298-8653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 S MERAMEC AVE STE 303",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631053514",
"telephone_number": "423-298-8653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLBROOK",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-25",
"last_updated": "2020-03-25",
"certification_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2018045606",
"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 Mar 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.