Active NPI
Virginia R Eades, PHD., LPC
- Professional Counselor
- Ballwin, MO
National Provider Identifier
1528097201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC 002232
- Practice address
- 707 Carman Meadows Dr
Ballwin, MO 63021-7174 - Phone
- (636) 391-3310
- Fax
- (636) 391-3310
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC 002232 | MO | Primary |
Addresses
Primary practice location
707 Carman Meadows Dr
Ballwin, MO 63021-7174
Mailing address
707 Carman Meadows Dr
Ballwin, MO 63021-7174
Phone (636) 391-3310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122115 | Other | MO | BLUE CROSS BLUE SHIELD |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC 002232 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200873600000",
"number": "1528097201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 CARMAN MEADOWS DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217174",
"telephone_number": "636-391-3310",
"fax_number": "636-391-3310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 CARMAN MEADOWS DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217174",
"telephone_number": "636-391-3310",
"fax_number": "636-391-3310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EADES",
"first_name": "VIRGINIA",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PHD., LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2008-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "LPC 002232",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "122115",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.