Organization Active NPI

Awakened Life Healing, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kirkwood, MO
National Provider Identifier
1366073546
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
AWAKENED LIFE HEALING, LLC
Practice address
10801 Big Bend Rd
Kirkwood, MO 63122-6055
Phone
(314) 467-0441
Fax
(314) 677-3512
NPI assigned
Jan 28, 2020
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Sarah Buehner, LCSWNPI 1619241254
Title
Owner
Phone
(410) 303-8946

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

10801 Big Bend Rd
Kirkwood, MO 63122-6055

Mailing address

597 Summit View Dr
Fenton, MO 63026-3847
Phone (314) 640-5846

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1366073546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 SUMMIT VIEW DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263847",
            "telephone_number": "314-640-5846",
            "fax_number": "314-677-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 BIG BEND RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226055",
            "telephone_number": "314-467-0441",
            "fax_number": "314-677-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKENED LIFE HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "BUEHNER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-303-8946",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.