Image Changed Counseling and Consultation LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2010036934 Issued in MO

Legal business name

IMAGE CHANGED COUNSELING AND CONSULTATION LLC

Practice address

225 S Meramec Ave
Ste 218
Clayton, MO 63105-3511

Phone

(314) 323-0463

NPI assigned

Jul 27, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Tia Jenice Morris, MSW, ACSW, LCSW

Title

Owner/Therapist

Phone

(314) 323-0463

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Justin E Hampton, LCSW

  • Clinical Social Worker
  • Effingham, IL
  • NPI 1184001380
  NPD (past)

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311811200000",
    "number": "1508144395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "STE 218",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053511",
            "telephone_number": "314-323-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "STE 218",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053511",
            "telephone_number": "314-323-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE CHANGED COUNSELING AND CONSULTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-28",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "TIA",
        "authorized_official_middle_name": "JENICE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "314-323-0463",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW, ACSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010036934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245532894",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Hubbard, LPC
• Emily Hudson, ND, LPC
• Yalaka Huyette
• Caitlyn Marie Hyde
• Sonya Bellomy Iliff, LPC
• Michelle M Ingram, MA CCC/SLP
• Institute for Regenerative Meidicine LLC
• Institute of Personalized Medicine LLC
• Iowa Home Healthcare Services LLC
• Ernest W Jackson, DDS

• Clinical Social Worker in Clayton, MO
• Providers in Clayton, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.