Mercedes Wilburn, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2016045130 Issued in MO

Practice address

3751 Pennridge Dr Ste 119
Bridgeton, MO 63044-1244

Phone

(636) 336-6874

NPI assigned

Feb 1, 2020

Last updated

Feb 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seven Counseling and Coaching LLC

  • Professional Counselor
  • Bridgeton, MO
  • NPI 1396469888
  NPD Authorized official

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

{
    "created_epoch": "1580515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580515200000",
    "number": "1477184075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 BLUEGRASS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631371209",
            "telephone_number": "314-783-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 PENNRIDGE DR STE 119",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630441244",
            "telephone_number": "636-336-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "MERCEDES",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-01",
        "last_updated": "2020-02-01",
        "certification_date": "2020-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2016045130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "computer",
            "affiliation": "N",
            "address_1": "3751 Pennridge Dr Ste 119",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630441244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cynthia Whiteside
• Bryan Thomas Whitlow, M.D.
• Patricia Whitney
• William Cody Whitworth, PHARM D
• Shelley Elizabeth Wichmann, PT
• Erin Wilcox
• Jessica Wild, FNP
• Alyssa Wilde, PT
• Stacy M Wiley, NURSE PRACTITIONER
• Jenna Avery Wilken, BSN, RN, CCRN

• Professional Counselor in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2020; 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.