Stacie Gorden

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2015045059 Issued in MO

Practice address

3751 Pennridge Dr Ste 119
Bridgeton, MO 63044-1244

Phone

(314) 744-9276

NPI assigned

Jun 13, 2016

Last updated

Feb 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stacie Hinton Former name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Of a Sound Mind Counseling LLC

  • Mental Health Counselor
  • Bridgeton, MO
  • NPI 1568001113
  NPD Authorized official

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1316397110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5522 MCLARAN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631361247",
            "telephone_number": "314-276-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 PENNRIDGE DR STE 119",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441244",
            "telephone_number": "314-744-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDEN",
        "first_name": "STACIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2015045059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACIE",
            "last_name": "HINTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• S Vic Glogovac, MD
• Kylie Glotta, DPT
• Anoj Kumar Goel, M.D.
• Charles Gonzales, M.D.
• Molly Goodman, NP
• Thomas Gordon, PHARM D
• Mary Jo Gorman, M.D.
• Bryan John Goss, ACNP
• Thomas Michael Gotsis, DDS
• Kaitlyn Taylor Kristina Gotthardt

• Mental Health Counselor in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.