Active NPI
Kristin Nicole Fleagle, EDM, LPC-ASSOCIATE
- Mental Health Counselor
- Saint Charles, MO
National Provider Identifier
1407730930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 96422
- Practice address
- 2451 Executive Dr Ste 205
Saint Charles, MO 63303-5606 - Phone
- (314) 375-6599
- NPI assigned
- Aug 5, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 96422 | TX | Primary |
Addresses
Primary practice location
2451 Executive Dr Ste 205
Saint Charles, MO 63303-5606
Mailing address
12000 FM 1171 Apt 6307
Northlake, TX 76262-6022
Phone (920) 323-9561
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
| License | State | Type | Specialty |
|---|---|---|---|
| 96422 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1407730930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12000 FM 1171 APT 6307",
"city": "NORTHLAKE",
"state": "TX",
"postal_code": "762626022",
"telephone_number": "920-323-9561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2451 EXECUTIVE DR STE 205",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633035606",
"telephone_number": "314-375-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLEAGLE",
"first_name": "KRISTIN",
"middle_name": "NICOLE",
"credential": "EDM, LPC-ASSOCIATE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-05",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "96422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.