Individual provider Active NPI

Judith Ruth Meredith, LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1396758207
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002816 Issued in MO
Practice address
11715 Administration Dr
Ste. 101
Saint Louis, MO 63146-4600
Phone
(636) 255-0835
Fax
(636) 255-0835
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 002816 MO Primary

Addresses

Primary practice location

11715 Administration Dr
Ste. 101
Saint Louis, MO 63146-4600

Mailing address

1147 Pike St
Saint Charles, MO 63301-2907
Phone (636) 255-0835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
002816MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396758207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 PIKE ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012907",
            "telephone_number": "636-255-0835",
            "fax_number": "636-255-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 ADMINISTRATION DR",
            "address_2": "STE. 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464600",
            "telephone_number": "636-255-0835",
            "fax_number": "636-255-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "JUDITH",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "002816",
            "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 Jul 9, 2007; 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.