Organization Active NPI

Polaris Wellness and Healing, LLC

  • Counselor
  • Fenton, MO
National Provider Identifier
1568376572
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
POLARIS WELLNESS AND HEALING, LLC
Practice address
655 Greensleeves Dr
Fenton, MO 63026-3343
Phone
(636) 359-3454
NPI assigned
Sep 29, 2026
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Angel M Coleman, LPC
Title
Owner
Phone
(636) 359-3454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

655 Greensleeves Dr
Fenton, MO 63026-3343

Mailing address

655 Greensleeves Dr
Fenton, MO 63026-3343
Phone (636) 359-3454

NPI Registry JSON

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1568376572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 GREENSLEEVES DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263343",
            "telephone_number": "636-359-3454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 GREENSLEEVES DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263343",
            "telephone_number": "636-359-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLARIS WELLNESS AND HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-359-3454",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.