Individual provider Active NPI

Stanley Archie

  • Mental Health Counselor
  • Kansas City, MO
National Provider Identifier
1508266131
Registry record updated Jul 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2012037387 Issued in MO
Practice address
8301 State Line Rd Ste 203
Kansas City, MO 64114-2019
Phone
(816) 807-6605
NPI assigned
Sep 2, 2014
Last updated
Jul 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2012037387 MO Primary

Addresses

Primary practice location

8301 State Line Rd Ste 203
Kansas City, MO 64114-2019

Mailing address

8301 State Line Rd Ste 203
Kansas City, MO 64114-2019
Phone (816) 807-6605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260219000678 MO Practitioner - Mental Health Counselor 7416437231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012037387MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC CurrentSince Feb 5, 2026 Accepting new patients
Successful Edge, LLC. Mental Health Past Accepting new patients

Locations

107 W 9th St
Fl 2
Kansas City, MO 64105
Phone (505) 382-2776

4625 Lindell Blvd
Ste 200300
Saint Louis, MO 63108
Phone (314) 639-0990

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1508266131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 STATE LINE RD STE 203",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142019",
            "telephone_number": "816-807-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 STATE LINE RD STE 203",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641142019",
            "telephone_number": "816-807-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHIE",
        "first_name": "STANLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-02",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2012037387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.