NPIMap

Organization Active NPI

Indvidualized Therapy & Care, P.C.

  • Counseling Psychologist
  • Saint Louis, MO
National Provider Identifier
1356550289
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
01800 Issued in MO
Legal business name
INDVIDUALIZED THERAPY & CARE, P.C.
Practice address
5858 White Pine Dr
Saint Louis, MO 63129-2954
Phone
(314) 894-9438
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Bonnie K Schwender
Title
Owner
Phone
(314) 894-9438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X 01800 MO Primary

Addresses

Primary practice location

5858 White Pine Dr
Saint Louis, MO 63129-2954

Mailing address

5858 White Pine Dr
Saint Louis, MO 63129-2954
Phone (314) 894-9438

Other identifiers 1

IdentifierTypeStateIssuer
494788409MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1356550289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 WHITE PINE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292954",
            "telephone_number": "314-894-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 WHITE PINE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631292954",
            "telephone_number": "314-894-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDVIDUALIZED THERAPY & CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "SCHWENDER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-894-9438"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "01800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494788409",
            "state": "MO"
        }
    ],
    "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 Jun 16, 2008; 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.