Individual provider Active NPI

Taylore Qaoud, MA, LPC, NCC

  • Mental Health Counselor
  • Saint Louis, MO
National Provider Identifier
1346621794
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2017039464 Issued in MO
Practice address
2831 Accomac St
Saint Louis, MO 63104-2239
Phone
(314) 325-4969
Fax
(314) 325-4969
NPI assigned
Jun 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2017039464 MO Primary

Addresses

Primary practice location

2831 Accomac St
Saint Louis, MO 63104-2239

Mailing address

2831 Accomac St
Saint Louis, MO 63104-2239
Phone (314) 325-4969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2017039464MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Roots Counseling, LLC Mental Health CurrentSince Apr 6, 2021 Accepting new patients

Locations

1034 S Brentwood Blvd
Ste 555
Saint Louis, MO 63117
Phone (314) 252-0392

2838 S Grand Blvd
Saint Louis, MO 63118
Phone (314) 399-8842

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1346621794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 ACCOMAC ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042239",
            "telephone_number": "314-325-4969",
            "fax_number": "314-325-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 ACCOMAC ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042239",
            "telephone_number": "314-325-4969",
            "fax_number": "314-325-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAOUD",
        "first_name": "TAYLORE",
        "name_prefix": "Ms.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2017039464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.