Counseling St. Charles, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2010012405 Issued in MO

Legal business name

COUNSELING ST. CHARLES, LLC

Practice address

225 S Main St
Ste 103
O Fallon, MO 63366-2866

Phone

(636) 294-0015

NPI assigned

Aug 6, 2012

Organization subpart

No

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

Authorized official

Name

Shannon Roberson, LPCNPI 1093015257

Title

Owner

Phone

(636) 294-0015

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Counseling St Charles LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Counseling St. Charles, LLC

  • Case Management Agency
  • O Fallon, MO
  • NPI 1811248537
  NPD tax ID

Practitioners 1

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

• Shannon Roberson, LPC

  • Professional Counselor
  • O Fallon, MO
  • NPI 1093015257
  NPD (past) Authorized official

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344211200000",
    "number": "1316294630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 486",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633660486",
            "telephone_number": "636-294-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MAIN ST",
            "address_2": "STE 103",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662866",
            "telephone_number": "636-294-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ST. CHARLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-06",
        "last_updated": "2012-08-06",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-294-0015",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MO",
            "license": "2010012405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1093015257",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cooper Family Chiropractic LLC
• Matthew Christopher Cooper, D.C
• Cornerstone Care Management, LLC
• Corporate Surgical Arts LLC
• Christine C Cortadillo, D.O.
• Counseling St. Charles, LLC
• Cowser Spine and Sport
• Steven Michael Cowser, DC
• Shannon Marie McDermott Crandall, LCSW
• Catherine L Crass, WHNP

• Community/Behavioral Health Agency in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; 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.