Individual provider Active NPI

Amy McDonnell, PLPC

  • Counselor
  • O Fallon, MO
National Provider Identifier
1548073380
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2024029141 Issued in MO
Practice address
1137 N Main St
O Fallon, MO 63366-1498
Phone
(636) 336-6165
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2024029141 MO Primary

Addresses

Primary practice location

1137 N Main St
O Fallon, MO 63366-1498

Mailing address

4 Country View CT
Wentzville, MO 63385-2321
Phone (636) 248-5281

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

State licenses

LicenseStateTypeSpecialty
2024029141MOMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Hearts LLC Counselor CurrentSince Feb 2, 2025 Accepting new patients

Locations

1137 N Main St
O Fallon, MO 63366
Phone (636) 294-2694

Organizations & group practices 1

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": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1548073380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COUNTRY VIEW CT",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633852321",
            "telephone_number": "636-248-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 N MAIN ST",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633661498",
            "telephone_number": "636-336-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONNELL",
        "first_name": "AMY",
        "credential": "PLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2024029141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.