Edward Flynn

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2014000915 Issued in MO

Practice address

5261 Delmar Blvd
Suite 214
Saint Louis, MO 63108-1063

Phone

(314) 497-6617

Fax

(314) 454-5715

NPI assigned

Feb 11, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Lakeside Behavioral Health LLCGroup PAC ID 9436439510, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lakesidebehavioral.edwardflynn@134654.advancedmd-direct.com

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.

• Lakeside Behavioral Health, LLC

  • Psychiatry Physician
  • Saint Louis, MO
  • NPI 1093269003
  Medicare reassignment Care Compare group NPD
• Good Newz Media Group LLC

  dba Therapeutic Alliance

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1689979692
  NPD (past)

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1588088538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 WYOMING ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163920",
            "telephone_number": "314-378-0290",
            "fax_number": "314-454-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5261 DELMAR BLVD",
            "address_2": "SUITE 214",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081063",
            "telephone_number": "314-497-6617",
            "fax_number": "314-454-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "EDWARD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2014000915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk E Flury, M.D.
• Abigail Flynn, AUD
• Anneliese Flynn
• Brenda J. Flynn, MSW, ACSW, LCSW
• Cathy Flynn, LCSW
• James Timothy Flynn, D.C.
• Julie Cristyn Flynn, MPT
• Kyle William Flynn, DPT
• Lauren Flynn, M.D.
• Megan Flynn

• Mental Health Counselor in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.