Kingdom House

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KINGDOM HOUSE

Doing business as

LifeWise StL

Practice address

1321 S 11TH St
Saint Louis, MO 63104-3599

Phone

(314) 421-0400

NPI assigned

May 20, 2024

Last updated

May 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Sarah M Caldera Wimmer, LCSW

Title

Director of Emotional & Physical We

Phone

(314) 420-0400

Specialties & licenses 1

Addresses

Other names 1

• LifeWise StL Doing business as

Locations

Practitioners 2

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.

• Sara Maria Johnson-Cardona, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
  • NPI 1164261277
  NPD
• Celine Noelle Reinoso, MSW, LMSW

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1053150144
  NPD

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1427897578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 S 11TH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631043599",
            "telephone_number": "314-421-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 S 11TH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631043599",
            "telephone_number": "314-421-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGDOM HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "CALDERA WIMMER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF EMOTIONAL & PHYSICAL WE",
        "authorized_official_telephone_number": "314-420-0400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeWise StL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tessa Marie King, MD
• Thomas R King, MD
• Wilson Tzu-Yung King, M.D.
• Kingdom Choice Healthcare LLC
• Kingdom Health Services LLC
• Kingdom Resources Ministries, Inc
• Brenda L Kingen, D.C.
• Mason Alexander Kinghorn, LCSW
• TJ Kingsbury, LCSW
• Kingston Dental Center

• Community/Behavioral Health Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.