Mudar Soufian Ismail, PLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2024010478 Issued in MO

Practice address

4030 Chouteau Ave Ste 700
Saint Louis, MO 63110-1754

Phone

(314) 680-9374

Fax

(314) 645-7802

NPI assigned

Jul 25, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Monarch Immigrant Services

  • Clinic/Center
  • Saint Louis, MO
  • NPI 1942270863

  Professional

  NPD

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1306674890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 TREESIDE CT APT I",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630170716",
            "telephone_number": "636-856-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 CHOUTEAU AVE STE 700",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101754",
            "telephone_number": "314-680-9374",
            "fax_number": "314-645-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "MUDAR",
        "middle_name": "SOUFIAN",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2024010478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Takaaki Ishiyama, M.D.
• Amina Islam, MD
• Aseeyah Ambreen Islam
• Daaiyah Khaleelah Islam, RN
• Hajar Ismail
• Briana Nicole Isom-Brummer
• Laura Isom
• Monique Isom
• Kavita Israni-Winger, MD, PHD
• Carmen Marie Isringhausen, ACNP

• 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 Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.