Organization Active NPI

Brooke Justis Counseling, LLC

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1396540589
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
BROOKE JUSTIS COUNSELING, LLC
Practice address
4037 Magnolia Ave
Saint Louis, MO 63110-3913
Phone
(314) 640-6068
NPI assigned
Feb 13, 2025
Last updated
Feb 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Brooke Justis, LCSWNPI 1942591169
Title
Owner
Phone
(314) 640-6068

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

4037 Magnolia Ave
Saint Louis, MO 63110-3913

Mailing address

4037 Magnolia Ave
Saint Louis, MO 63110-3913
Phone (314) 640-6068

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250425001107 MO Part B Supplier - Clinic/Group Practice 8224554951 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

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": "1739404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1396540589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 MAGNOLIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103913",
            "telephone_number": "314-640-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 MAGNOLIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631103913",
            "telephone_number": "314-640-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKE JUSTIS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-13",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "JUSTIS",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-640-6068",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Feb 13, 2025; 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.