Active NPI
Taijuana Wells, MA., LPC
- Professional Counselor
- Hazelwood, MO
National Provider Identifier
1649930645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2021042219
- Practice address
- 737 Dunn Rd
Hazelwood, MO 63042-1740 - Phone
- (314) 230-0362
- Fax
- (314) 731-4433
- NPI assigned
- Dec 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2021042219 | MO | Primary |
Addresses
Primary practice location
737 Dunn Rd
Hazelwood, MO 63042-1740
Mailing address
1501 Moonlight Dr
Saint Louis, MO 63135-1448
Phone (314) 338-1896
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 490106035 | Medicaid | MO |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021042219 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1649930645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 MOONLIGHT DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631351448",
"telephone_number": "314-338-1896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "737 DUNN RD",
"city": "HAZELWOOD",
"state": "MO",
"postal_code": "630421740",
"telephone_number": "314-230-0362",
"fax_number": "314-731-4433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "TAIJUANA",
"credential": "MA., LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-19",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2021042219",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "490106035",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hazelwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.