Active NPI
Mary Alice Grady, PLPC
- Professional Counselor
- Saint Louis, MO
National Provider Identifier
1265160071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2021026439
- Practice address
- 6245 Pershing Ave
Saint Louis, MO 63130-4802 - Phone
- (314) 265-1195
- NPI assigned
- Aug 10, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 2021026439 | MO | Primary |
Addresses
Primary practice location
6245 Pershing Ave
Saint Louis, MO 63130-4802
Mailing address
6245 Pershing Ave
Saint Louis, MO 63130-4802
Phone (314) 265-1195
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 |
|---|---|---|---|
| 2021026439 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660089600000",
"number": "1265160071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6245 PERSHING AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631304802",
"telephone_number": "314-265-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6245 PERSHING AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631304802",
"telephone_number": "314-265-1195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "MARY",
"middle_name": "ALICE",
"credential": "PLPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-10",
"last_updated": "2022-08-10",
"certification_date": "2022-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2021026439",
"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 Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.