Organization Active NPI

Liberate Learning Institute

  • Community/Behavioral Health Agency
  • Saint Louis, MO
National Provider Identifier
1467802322
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIBERATE LEARNING INSTITUTE
Practice address
801 N 11TH St
Saint Louis, MO 63101-1015
Phone
(314) 690-9433
NPI assigned
Jun 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Authorized official

Name
Mr. Jon-Pierre Mitchom, PLPCNPI 1699284398
Title
Founder/Ceo
Phone
(314) 690-9433

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MO
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X MO
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X MO
Community/Behavioral Health Agency 251S00000X MO Primary

Addresses

Primary practice location

801 N 11TH St
Saint Louis, MO 63101-1015

Mailing address

3833 McRee Ave
Saint Louis, MO 63110-2619
Phone (314) 690-9433

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.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1467802322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3833 MCREE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102619",
            "telephone_number": "314-690-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N 11TH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011015",
            "telephone_number": "314-690-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERATE LEARNING INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "MITCHOM",
        "authorized_official_first_name": "JON-PIERRE",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "314-690-9433",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PLPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MO",
            "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 Jun 24, 2016; 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.