Rebecca Ann Materniak, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2016008460 Issued in MO

Practice address

140 Professional Pkwy
Troy, MO 63379-2823

Phone

(636) 528-5911

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

Yes

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.

• Catholic Family Services Inc.

  • Mental Health Counselor
  • Union, MO
  • NPI 1154480176
  NPD (past)
• St Louis Counseling Inc

  • Voluntary or Charitable Agency
  • Fenton, MO
  • NPI 1053397133
  NPD (past)

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1700316643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 PIEDMONT CIR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633045680",
            "telephone_number": "636-542-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PROFESSIONAL PKWY",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792823",
            "telephone_number": "636-528-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 S Main St",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633662807",
            "country_code": "US",
            "telephone_number": "636-281-1990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATERNIAK",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2016008460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "2016008460",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce Maixner, FNP-BC
• Katherine Manning
• Mark Jay Beckwith
• Taylor Laray Martin, DC
• Bradley James Massey, D.O.
• Timothy McCullough, MD
• Destany Danielle McDaniel, LCSW
• Kathleen Anne McKean, DNP
• Kim Dawn McMillian, APRN
• Nicole Marie McNeil, LPC

• Professional Counselor in Troy, MO
• Providers in Troy, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.