Covenant House Missouri

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

2004036418 Issued in MO

Legal business name

COVENANT HOUSE MISSOURI

Practice address

2727 N Kingshighway Blvd
Saint Louis, MO 63113-1006

Phone

(314) 450-7667

Fax

(314) 454-0005

NPI assigned

Dec 24, 2009

Last updated

Dec 24, 2009By 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. Kristina R Kersting, MALPC

Title

Clinical Coordinator

Phone

(314) 450-7667

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261612800000",
    "number": "1467781393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 N. KINGSHIGHWAY BOULEVARD",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63113",
            "telephone_number": "314-450-7667",
            "fax_number": "314-454-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 N KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631131006",
            "telephone_number": "314-450-7667",
            "fax_number": "314-454-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOUSE MISSOURI",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A",
        "authorized_official_last_name": "KERSTING",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "314-450-7667",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MALPC"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MO",
            "license": "2004036418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457324485",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499019503",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Couts McAdam Osteopathic Family Medicine
• Couts McAdam Osteopathic Family Medicine,LLC (James R McAdam, D.O.)
• Ivan Covas-Maldonado, M.D.
• Covenant Care in-Home Agency LLC.
• Covenant Consumer Directed Services LLC
• Andrea Michele Coverstone, MD
• Edward David Coverstone, MD
• James Covey, CRNA
• Stacy Ruter Covey, R.D., L.D.
• Stephanie I E Covey, RNFA

• Emotionally Disturbed Childrens' Residential Treatment Facility in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.