Jessica Lynne McDonald

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2017009266 Issued in MO

Practice address

1150 Graham Rd
Florissant, MO 63031-8077

Phone

(314) 206-3412

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Burrell, Inc.

  • Community/Retail Pharmacy
  • Springfield, MO
  • NPI 1194190066
  NPD (past)
• Burrell, Inc.

  • Community/Behavioral Health Agency
  • Springfield, MO
  • NPI 1275541740
  NPD (past)

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1679005136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 OLIVE ST STE 400",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631032303",
            "telephone_number": "314-206-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-206-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JESSICA",
        "middle_name": "LYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2017009266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "2017009266",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy McCoy
• Severin McCoy, DDS
• Sheila McCoy
• Niesha McDaniel, LPN
• Dylan McDonald, PHARMD
• Kim L McDonald, M.D.
• Syn Marie McDonald, M.A., BCBA
• Stephanie Grace McElwrath, OTR/L
• Evelyn McEvoy, CRNA
• Jacquelyn Renee McFadden, MD

• Mental Health Counselor in Florissant, MO
• Providers in Florissant, 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 Sep 1, 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.