Individual provider Active NPI

Joshua D Kurth, PH.D., LPC

  • Professional Counselor
  • Waterloo, IL
National Provider Identifier
1194975185
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2007011891 Issued in MO
Practice address
102 W Mill St Unit 6a
Waterloo, IL 62298-1917
Phone
(314) 399-7202
NPI assigned
Sep 25, 2008
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2007011891 MO Primary

Addresses

Primary practice location

102 W Mill St Unit 6a
Waterloo, IL 62298-1917

Mailing address

5855 LRC Rd
Waterloo, IL 62298-6557
Phone (314) 637-7443

Other practice location 1

4225 Bayless Ave
Saint Louis, MO 63123-7513
Phone (314) 637-7443

Other identifiers 1

IdentifierTypeStateIssuer
1194975185MedicaidMO

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2007011891MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Going Public Ministries Professional Past Accepting new patients
JN Wellness Inc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1194975185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 LRC RD",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622986557",
            "telephone_number": "314-637-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W MILL ST UNIT 6A",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981917",
            "telephone_number": "314-399-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4225 Bayless Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631237513",
            "country_code": "US",
            "telephone_number": "314-637-7443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KURTH",
        "first_name": "JOSHUA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-25",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2007011891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194975185",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.