NPIMap

Organization Active NPI

The Center for Mental Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clayton, MO
National Provider Identifier
1376211359
Registry record updated Jul 5, 2023
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
THE CENTER FOR MENTAL WELLNESS, LLC
Practice address
121 Hunter Ave Ste 202
Clayton, MO 63124-2083
Phone
(314) 474-8804
NPI assigned
Sep 2, 2021
Last updated
Jul 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Natasha Doherty, LCSWNPI 1659723724
Title
President, Ceo
Phone
(314) 474-8804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

121 Hunter Ave Ste 202
Clayton, MO 63124-2083

Mailing address

121 Hunter Ave Ste 202
Clayton, MO 63124-2083
Phone (314) 474-8804

Other practice location 1

200 S Hanley Rd Ste 504
Clayton, MO 63105-3415
Phone (314) 474-8004

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL natasha@survivethrivetherapy.com
Other URL Natasha@mentallywellstl.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250225003383 MO Part B Supplier - Clinic/Group Practice 5991225518 Receives reassigned benefits from 8 practitioners
Practice locations: Clayton, MO

National Provider Directory

National Provider Directory

Locations

200 S Hanley Rd
Ste 504
Clayton, MO 63105
Phone (314) 474-8004

121 Hunter Ave
Ste 202
Saint Louis, MO 63124
Phone (314) 474-8804

Practitioners & affiliated clinicians

Practitioners 11

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": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1376211359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 HUNTER AVE STE 202",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631242083",
            "telephone_number": "314-474-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 HUNTER AVE STE 202",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631242083",
            "telephone_number": "314-474-8804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 S Hanley Rd Ste 504",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "MO",
            "postal_code": "631053415",
            "country_code": "US",
            "telephone_number": "314-474-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE CENTER FOR MENTAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2023-07-05",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "NATASHA",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "314-474-8804",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "natasha@survivethrivetherapy.com",
            "affiliation": "N",
            "address_1": "200 S Hanley Rd Ste 504",
            "city": "Clayton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631053415",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Natasha@mentallywellstl.com",
            "affiliation": "N",
            "address_1": "121 Hunter Ave Ste 202",
            "city": "Clayton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631242083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.