Individual provider Active NPI

Amy Marie Goldstein, MA, LPC, CSAM, CSAT

  • Counselor
  • Saint Louis, MO
National Provider Identifier
1295359354
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2020010969 Issued in MO
Practice address
9666 Olive Blvd Ste 370
Saint Louis, MO 63132-3025
Phone
(636) 577-2397
NPI assigned
Jun 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 2020010969 MO Primary

Addresses

Primary practice location

9666 Olive Blvd Ste 370
Saint Louis, MO 63132-3025

Mailing address

9666 Olive Blvd Suite 370
Creve Coeur, MO 63132-3000
Phone (636) 577-2397

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@agcounseling.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2020010969MOMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1295359354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9666 OLIVE BLVD SUITE 370",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631323000",
            "telephone_number": "636-577-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9666 OLIVE BLVD STE 370",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631323025",
            "telephone_number": "636-577-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "credential": "MA, LPC, CSAM, CSAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "MO",
            "license": "2020010969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@agcounseling.net",
            "affiliation": "N",
            "endpointDescription": "Direct Business email contact",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "9666 Olive Blvd Ste 330",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631323035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.