Individual provider Active NPI

Gayle G Anderson, PLPC

  • Professional Counselor
  • Saint Charles, MO
National Provider Identifier
1205150208
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2010008296 Issued in MO
Practice address
2850 W Clay St Ste 255
Saint Charles, MO 63301-2579
Phone
(636) 699-0872
NPI assigned
Mar 18, 2010
Last updated
Jan 31, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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 2010008296 MO Primary

Addresses

Primary practice location

2850 W Clay St Ste 255
Saint Charles, MO 63301-2579

Mailing address

11 Bay Oaks CT
Lake Saint Louis, MO 63367-2127
Phone (636) 699-0872

Other identifiers 1

IdentifierTypeStateIssuer
2010008296MedicaidMO

Other names 1

  • Mr. Andy Anderson Other name

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

LicenseStateTypeSpecialty
2010008296MOMDProfessional Counselor

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, 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": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1205150208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BAY OAKS CT",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633672127",
            "telephone_number": "636-699-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W CLAY ST STE 255",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012579",
            "telephone_number": "636-699-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GAYLE",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-18",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2010008296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010008296",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDY",
            "last_name": "ANDERSON",
            "prefix": "MR.",
            "credential": "PLPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.