Kelly Kubala Mehan, L.C.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2006018306 Issued in MO

Practice address

408 Jefferson Street
St. Charles, MO 63301

Phone

(314) 440-5800

NPI assigned

Jun 28, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1376740829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5854 WALSH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631093120",
            "telephone_number": "314-440-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 JEFFERSON STREET",
            "city": "ST. CHARLES",
            "state": "MO",
            "postal_code": "63301",
            "telephone_number": "314-440-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHAN",
        "first_name": "KELLY",
        "middle_name": "KUBALA",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006018306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sue McNeill, SLP
• Greg McPherson, D.D.S.
• Stephanie Renee McRight, LPC
• Med X Change, LLC
• Medsure Medical LLC
• Mona Margaret Mehl-Rudd, MS PT
• Shital Mehta
• Viktoria Meier, AGNP
• Lori Ann Meinert, MHS, PT
• Jean Melchior, MSW, LCSW, ACSW

• Clinical Social Worker in St. Charles, MO
• Providers in St. Charles, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2013; 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.