NPIMap

Organization Active NPI

Provident

  • Preferred Provider Organization
  • Arnold, MO
National Provider Identifier
1316005473
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
SW002589 Issued in MO
Legal business name
PROVIDENT
Practice address
3675 W Outer Rd
203
Arnold, MO 63010-5232
Phone
(314) 898-0102
Fax
(636) 296-3249
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Kristin Bulin, MSW
Title
Director of Counseling Division
Phone
(314) 371-6500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 002589 MO
Preferred Provider Organization 305R00000X SW002589 MO Primary

Addresses

Primary practice location

3675 W Outer Rd
203
Arnold, MO 63010-5232

Mailing address

3675 W Outer Rd
203
Arnold, MO 63010-5232
Phone (314) 898-0102

Other identifiers 1

IdentifierTypeStateIssuer
496768326MedicaidMO

National Provider Directory

National Provider Directory
Tax ID family
Provident Counceling in4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1316005473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 W OUTER RD",
            "address_2": "203",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630105232",
            "telephone_number": "314-898-0102",
            "fax_number": "636-296-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 W OUTER RD",
            "address_2": "203",
            "city": "ARNOLD",
            "state": "MO",
            "postal_code": "630105232",
            "telephone_number": "314-898-0102",
            "fax_number": "636-296-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BULIN",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "DIRECTOR OF COUNSELING DIVISION",
        "authorized_official_telephone_number": "314-371-6500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MO",
            "license": "002589",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MO",
            "license": "SW002589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496768326",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.