Individual provider Active NPI

Gloria Stephen, LPC

  • Professional Counselor
  • Saint Charles, MO
National Provider Identifier
1265734511
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2010003617 Issued in MO
Practice address
1550 Wall St
Suite 231
Saint Charles, MO 63303-3545
Phone
(636) 925-0604
NPI assigned
Nov 18, 2010
Last updated
Mar 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 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 2010003617 MO Primary

Addresses

Primary practice location

1550 Wall St
Suite 231
Saint Charles, MO 63303-3545

Mailing address

1550 Wall St Ste 231
Saint Charles, MO 63303-3546
Phone (636) 293-0044

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
I20250519002231 MO Practitioner - Mental Health Counselor 0244758753 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Restoration Counseling, LLC Professional CurrentSince Mar 5, 2025 Accepting new patients

Locations

1550 Wall St
Ste 231
Saint Charles, MO 63303
Phone (636) 293-0044

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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1265734511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 WALL ST STE 231",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033546",
            "telephone_number": "636-293-0044",
            "fax_number": "636-724-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 WALL ST",
            "address_2": "SUITE 231",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033545",
            "telephone_number": "636-925-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHEN",
        "first_name": "GLORIA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2010003617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.