Individual provider Active NPI

Tara Stevens, LPC

  • Professional Counselor
  • Saint Charles, MO
National Provider Identifier
1548933674
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2016045145 Issued in MO
Practice address
3910 S Old Highway 94 Ste 121
Saint Charles, MO 63304-2834
Phone
(314) 585-9916
NPI assigned
Jul 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2016045145 MO Primary

Addresses

Primary practice location

3910 S Old Highway 94 Ste 121
Saint Charles, MO 63304-2834

Mailing address

3910 S Old Highway 94 Ste 121
Saint Charles, MO 63304-2834
Phone (314) 585-9916

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
2016045145MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Wealth Solutions, LLC Professional CurrentSince Dec 12, 2021 Accepting new patients

Locations

3910 S Old Highway 94
Ste 121
Saint Charles, MO 63304
Phone (314) 585-9916

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": "1627257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1548933674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3910 S OLD HIGHWAY 94 STE 121",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633042834",
            "telephone_number": "314-585-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 S OLD HIGHWAY 94 STE 121",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633042834",
            "telephone_number": "314-585-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TARA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2016045145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.