NPIMap

Organization Active NPI

St Charles West Psychological

  • Clinical Psychologist
  • Wentzville, MO
National Provider Identifier
1538243571
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ST CHARLES WEST PSYCHOLOGICAL
Practice address
600 Medical Dr Ste 205
Wentzville, MO 63385-3426
Phone
(314) 432-2580
Fax
(314) 432-0223
NPI assigned
Oct 25, 2006
Last updated
Aug 31, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Authorized official

Name
Valerie Andrade
Title
Acct Manager
Phone
(314) 432-2580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

600 Medical Dr Ste 205
Wentzville, MO 63385-3426

Mailing address

600 Medical Dr Ste 205
Wentzville, MO 63385-3426
Phone (314) 432-2580

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1538243571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MEDICAL DR STE 205",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853426",
            "telephone_number": "314-432-2580",
            "fax_number": "314-432-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MEDICAL DR STE 205",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853426",
            "telephone_number": "314-432-2580",
            "fax_number": "314-432-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CHARLES WEST PSYCHOLOGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "ANDRADE",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "ACCT MANAGER",
        "authorized_official_telephone_number": "314-432-2580"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.