Individual provider Active NPI

Michael Riley, CIT

  • Mental Health Counselor
  • Saint Louis, MO
National Provider Identifier
1689393423
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1612 S Big Bend Blvd
Saint Louis, MO 63117-2208
Phone
(314) 529-1391
NPI assigned
Aug 24, 2022
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1612 S Big Bend Blvd
Saint Louis, MO 63117-2208

Mailing address

1612 S Big Bend Blvd
Saint Louis, MO 63117-2208
Phone (314) 529-1391

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241017000665 MO Practitioner - Mental Health Counselor 2264964196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avenues Counseling CenterGroup PAC ID 9032557053, 5 clinicians

Practice addresses (Care Compare)

1612 S Big Bend Blvd
Saint Louis, MO 63117-2208
Phone (314) 529-1391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avenues Counseling Center Mental Health CurrentSince Sep 30, 2024 Accepting new patients
Avenues Counseling Center CurrentSince Jul 28, 2025 Accepting new patients

Locations

1612 S Big Bend Blvd
Saint Louis, MO 63117
Phone (314) 529-1391

409 S Florissant Rd
Ste 101
Saint Louis, MO 63135
Phone (314) 529-1391

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1689393423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 S BIG BEND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631172208",
            "telephone_number": "314-529-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 S BIG BEND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631172208",
            "telephone_number": "314-529-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MICHAEL",
        "credential": "CIT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.