Individual provider Active NPI

Marie Bonner-Horon

  • Mental Health Counselor
  • Saint Peters, MO
National Provider Identifier
1215487590
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2016032550 Issued in MO
Practice address
1555 Kisker Rd Ste 100
Saint Peters, MO 63304-0602
Phone
(636) 344-0580
Fax
(636) 206-2486
NPI assigned
Oct 10, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2016032550 MO Primary

Addresses

Primary practice location

1555 Kisker Rd Ste 100
Saint Peters, MO 63304-0602

Mailing address

3115 S Grand Blvd Ste 450
Saint Louis, MO 63118-1045
Phone (314) 577-0444

Other practice location 1

500 Huber Park Ct Ste 203
Weldon Spring, MO 63304-8683
Phone (636) 344-0580

Other identifiers 2

IdentifierTypeStateIssuer
490037465MedicaidMO
830151083MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1555 Kisker Rd
Suite 100
Saint Charles, MO 63304-0602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016032550MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Playhouse Collaborative Mental Health Current Accepting new patients
Ways of Play Counseling Services Mental Health Current Accepting new patients

Locations

1555 Kisker Rd
Ste 100
Saint Peters, MO 63304

500 Huber Park Ct
Ste 203
Weldon Spring, MO 63304
Phone (417) 289-2220

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1215487590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 S GRAND BLVD STE 450",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631181045",
            "telephone_number": "314-577-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 KISKER RD STE 100",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633040602",
            "telephone_number": "636-344-0580",
            "fax_number": "636-206-2486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Huber Park Ct Ste 203",
            "address_purpose": "LOCATION",
            "city": "Weldon Spring",
            "state": "MO",
            "postal_code": "633048683",
            "country_code": "US",
            "telephone_number": "636-344-0580",
            "fax_number": "636-206-2486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNER-HORON",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2016032550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490037465",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830151083",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.