Walter Robert Scull, M.ED., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2016040412 Issued in MO

Practice address

1300 Kirkham Ave
Saint Louis, MO 63122-3127

Phone

(314) 560-7205

NPI assigned

May 18, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

High Plains Mental Health CenterGroup PAC ID 6204748783, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

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.

• High Plains Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hays, KS
  • NPI 1710971429

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• High Plains Mental Health Center

  • Community/Behavioral Health Agency
  • Hays, KS
  • NPI 1871226944
  NPD (past)

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1306469960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 KIRKHAM AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223127",
            "telephone_number": "314-560-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 KIRKHAM AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223127",
            "telephone_number": "314-560-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULL",
        "first_name": "WALTER",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "M.ED., LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2016040412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Theranest",
            "affiliation": "N",
            "endpointDescription": "Theranest",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "1300 Kirkham Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631223127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evelyn Kay Scrivner, ACNP
• Madeline Scrivner, PT, DPT
• Kenneth B Scroggins, D.M.D.
• Stacey Scrogin, FNP
• Amber Scruton, R.N.
• Kristen Ann Scullin-Hartman, MD
• Thomas Scully, MD
• Camille Scurlock, AUD
• Tyrell Scurlock
• Monica A Scutariu, MD

• Professional Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.