The Tristn Jevon Center for Recovery

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

THE TRISTN JEVON CENTER FOR RECOVERY

Practice address

704 Wollard Blvd
Richmond, MO 64085-2205

Phone

(816) 470-0118

NPI assigned

Jul 30, 2021

Organization subpart

No

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

Authorized official

Name

Robert Cox, LPC

Title

Executive Director

Phone

(816) 470-0118

Specialties & licenses 4

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1639842016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 WOLLARD BLVD",
            "city": "RICHMOND",
            "state": "MO",
            "postal_code": "640852205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 WOLLARD BLVD",
            "city": "RICHMOND",
            "state": "MO",
            "postal_code": "640852205",
            "telephone_number": "816-470-0118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Westowne St",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "MO",
            "postal_code": "640681166",
            "country_code": "US",
            "telephone_number": "816-470-0118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE TRISTN JEVON CENTER FOR RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "816-470-0118",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Robert@tjrecovery.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "10 Westowne St",
            "city": "Liberty",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640681166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.