NPIMap

Organization Active NPI

Main Street Counseling, LLC

  • Clinical Social Worker
  • Saint Charles, MO
National Provider Identifier
1710158704
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2005040010 Issued in MO
Legal business name
MAIN STREET COUNSELING, LLC
Practice address
223 N Main St
Suite #3
Saint Charles, MO 63301-2828
Phone
(314) 484-6198
Fax
(636) 244-1933
NPI assigned
Mar 18, 2008
Last updated
Mar 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Cynthia Marie Eisenbeis, MSW LCSWNPI 1205883550
Title
Owner
Phone
(314) 484-6198

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2005040010 MO Primary

Addresses

Primary practice location

223 N Main St
Suite #3
Saint Charles, MO 63301-2828

Mailing address

223 N Main St
Suite #3
Saint Charles, MO 63301-2828
Phone (314) 484-6198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080325000008 MO Part B Supplier - Clinic/Group Practice 2062598600 Receives reassigned benefits from 12 practitioners
Practice locations: Saint Peters, MO

National Provider Directory

National Provider Directory

Locations

223 N Main St
Ste 3
Saint Charles, MO 63301
Phone (314) 397-3454

1284 Jungermann Rd
Ste B
Saint Peters, MO 63376
Phone (636) 498-0700

1286 Jungermann Rd
Saint Peters, MO 63376
Phone (636) 922-5000

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1710158704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "address_2": "SUITE #3",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012828",
            "telephone_number": "314-484-6198",
            "fax_number": "636-244-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "address_2": "SUITE #3",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012828",
            "telephone_number": "314-484-6198",
            "fax_number": "636-244-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "EISENBEIS",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-484-6198",
        "authorized_official_credential": "MSW LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005040010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.