Organization Active NPI

D. Early, PH.D., Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Louis, MO
National Provider Identifier
1306142278
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
2006028096 Issued in MO
Legal business name
D. EARLY, PH.D., INC.
Practice address
6220 S Lindbergh Blvd
Suite 300
Saint Louis, MO 63123-7839
Phone
(314) 894-2900
Fax
(314) 894-2960
NPI assigned
Feb 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
Dr. Debra J Early, PH.D.NPI 1649347329
Title
President, Licensed Psychologist
Phone
(314) 894-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2006028096 MO Primary

Addresses

Primary practice location

6220 S Lindbergh Blvd
Suite 300
Saint Louis, MO 63123-7839

Mailing address

6220 S Lindbergh Blvd
Suite 300
Saint Louis, MO 63123-7839
Phone (314) 894-2900

Other identifiers 2

IdentifierTypeStateIssuer
1649347329OtherMONPIN AS AN INDIVIDUAL PROVIDER
11798822OtherMOCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110406000369 MO Part B Supplier - Clinic/Group Practice 0345424966 Receives reassigned benefits from 1 practitioner
Practice locations: Wildwood, MO

National Provider Directory

National Provider Directory

Locations

6220 S Lindbergh Blvd
Ste 300
Saint Louis, MO 63123
Phone (314) 602-6650

2642 Highway 109
Ste E
Wildwood, MO 63040
Phone (636) 821-3193

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1306142278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 S LINDBERGH BLVD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237839",
            "telephone_number": "314-894-2900",
            "fax_number": "314-894-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 S LINDBERGH BLVD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237839",
            "telephone_number": "314-894-2900",
            "fax_number": "314-894-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D. EARLY, PH.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT, LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "314-894-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MO",
            "license": "2006028096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPIN AS AN INDIVIDUAL PROVIDER",
            "identifier": "1649347329",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11798822",
            "state": "MO"
        }
    ],
    "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 Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.