NPIMap

Organization Active NPI

Memoir Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Independence, MO
National Provider Identifier
1578192308
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MEMOIR COUNSELING, LLC
Practice address
4731 S Cochise Dr Ste 206
Independence, MO 64055-6975
Phone
(816) 373-6433
NPI assigned
Apr 3, 2020
Last updated
Apr 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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

Authorized official

Name
Margaux Kervin, LPC, CADCNPI 1194244541
Title
Provider
Phone
(816) 866-0334

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4731 S Cochise Dr Ste 206
Independence, MO 64055-6975

Mailing address

2906 NE Russell Rd
Kansas City, MO 64117-2167
Phone (913) 645-5733

Other identifiers 1

IdentifierTypeStateIssuer
1194244541MedicaidMO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585872000000",
    "number": "1578192308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 NE RUSSELL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641172167",
            "telephone_number": "913-645-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 S COCHISE DR STE 206",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556975",
            "telephone_number": "816-373-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMOIR COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A",
        "authorized_official_last_name": "KERVIN",
        "authorized_official_first_name": "MARGAUX",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "816-866-0334",
        "authorized_official_credential": "LPC, CADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194244541",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.