Individual provider Active NPI

Brooke Kraushaar, PSY.D.

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1477685477
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2007003961 Issued in MO
Practice address
1129 Macklind Ave
Saint Louis, MO 63110-1440
Phone
(314) 534-0200
Fax
(314) 534-7996
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2007003961 MO Primary

Addresses

Primary practice location

1129 Macklind Ave
Saint Louis, MO 63110-1440

Mailing address

4400 Collins Cir
Rogers, AR 72758-9047
Phone (479) 633-0022

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007003961MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy Shuman, LLC Past Accepting new patients
The Center for Mindfulness and CBT, LLC PastSince Jan 24, 2017 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477685477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 COLLINS CIR",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727589047",
            "telephone_number": "479-633-0022",
            "fax_number": "479-271-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MACKLIND AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101440",
            "telephone_number": "314-534-0200",
            "fax_number": "314-534-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSHAAR",
        "first_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2007003961",
            "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 Jul 8, 2007; 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.