Active NPI
Diane Kohm, LMFT
- Marriage & Family Therapist
- Saint Louis, MO
National Provider Identifier
1720481336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2014015296
- Practice address
- 1066 Executive Parkway Dr Ste 103
Saint Louis, MO 63141-6340 - Phone
- (314) 278-8938
- NPI assigned
- Sep 27, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 2014015296 | MO | Primary |
Addresses
Primary practice location
1066 Executive Parkway Dr Ste 103
Saint Louis, MO 63141-6340
Mailing address
1066 Executive Parkway Dr Ste 103
Saint Louis, MO 63141-6340
Phone (314) 278-8938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014015296 | MO | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411776000000",
"number": "1720481336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1066 EXECUTIVE PARKWAY DR STE 103",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416340",
"telephone_number": "314-278-8938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1066 EXECUTIVE PARKWAY DR STE 103",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416340",
"telephone_number": "314-278-8938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHM",
"first_name": "DIANE",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-27",
"last_updated": "2014-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MO",
"license": "2014015296",
"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 Sep 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.