Individual provider Active NPI

Stephanie Cooper, LMHC, LPC, CPC

  • Mental Health Counselor
  • Lake St Louis, MO
National Provider Identifier
1194368506
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61255915 Issued in WA
Practice address
8651 Highway N
Ste 100
Lake St Louis, MO 63367
Phone
(425) 470-3957
NPI assigned
Oct 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2022030373 MO
Mental Health Counselor 101YM0800X CP5404-R NV
Mental Health Counselor 101YM0800X LH61255915 WA Primary

Addresses

Primary practice location

8651 Highway N
Ste 100
Lake St Louis, MO 63367

Mailing address

8651 Highway N
Ste 100 PMB #3018
Lake St Louis, MO 63367
Phone (425) 470-3957

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: No
  • 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
I20260227000625 MO Practitioner - Mental Health Counselor 0345721338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

210 Beech Tree Dr
Troy, MO 63379-3362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2022030373MOMDMental Health Counselor
CP5404-RNVMDMental Health Counselor
LH61255915WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Ohio, Inc. CurrentSince Jan 20, 2026 Accepting new patients

Locations

13655 Riverport Dr
Maryland Hts, MO 63043
Phone (314) 592-3670

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": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1194368506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8651 HIGHWAY N",
            "address_2": "STE 100 PMB #3018",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "425-470-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8651 HIGHWAY N",
            "address_2": "STE 100",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "425-470-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STEPHANIE",
        "credential": "LMHC, LPC, CPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2022030373",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP5404-R",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61255915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake St Louis, MO

Sources for this page

Verify at the official NPI Registry.