Individual provider Active NPI

Kathy Lynn Gouwens, M.A., PLPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1730525916
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
20130112551 Issued in MO
Practice address
2388 Schuetz Rd Ste A10
Saint Louis, MO 63146-3401
Phone
(314) 898-0100
Fax
(314) 993-2828
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 20130112551 MO Primary

Addresses

Primary practice location

2388 Schuetz Rd Ste A10
Saint Louis, MO 63146-3401

Mailing address

2650 Olive St
Saint Louis, MO 63103-1489
Phone (143) 716-5003

Other practice location 1

1776 Crosswinds Dr
Wentzville, MO 63385-4832
Phone (636) 332-5835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
20130112551MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Provident Inc. CurrentSince May 25, 2021 Accepting new patients
Provident Inc PastSince May 25, 2021 Accepting new patients

Locations

2388 Schuetz Rd
Ste A10
Saint Louis, MO 63146
Phone (314) 802-2647

2650 Olive St
Saint Louis, MO 63103
Phone (314) 371-6500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1730525916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031489",
            "telephone_number": "143-716-5003",
            "fax_number": "314-371-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 SCHUETZ RD STE A10",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463401",
            "telephone_number": "314-898-0100",
            "fax_number": "314-993-2828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1776 Crosswinds Dr",
            "address_purpose": "LOCATION",
            "city": "Wentzville",
            "state": "MO",
            "postal_code": "633854832",
            "country_code": "US",
            "telephone_number": "636-332-5835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUWENS",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "M.A., PLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-15",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "20130112551",
            "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 May 18, 2021; 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.