Active NPI
Mary Pat Henehan, LMFT
- Marriage & Family Therapist
- Saint Louis, MO
National Provider Identifier
1710196050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 300016
- Practice address
- 16 Bon Hills Dr
Saint Louis, MO 63132-3602 - Phone
- (314) 854-0343
- Fax
- (314) 994-7640
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 300016 | MO | Primary |
Addresses
Primary practice location
16 Bon Hills Dr
Saint Louis, MO 63132-3602
Mailing address
16 Bon Hills Dr
Saint Louis, MO 63132-3602
Phone (314) 854-0343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 16, 2024 through Feb 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300016 | MO | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710196050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 BON HILLS DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631323602",
"telephone_number": "314-854-0343",
"fax_number": "314-994-7640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 BON HILLS DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631323602",
"telephone_number": "314-854-0343",
"fax_number": "314-994-7640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENEHAN",
"first_name": "MARY",
"middle_name": "PAT",
"name_prefix": "Dr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MO",
"license": "300016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.