Individual provider Active NPI

Mary Josepha Stralka, PHD

  • Professional Counselor
  • Ballwin, MO
National Provider Identifier
1750390035
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002411 Issued in MO
Practice address
13610 Barrett Office Dr
Suite 108
Ballwin, MO 63021-7816
Phone
(314) 965-2559
Fax
(314) 965-2559
NPI assigned
Aug 5, 2006
Last updated
Apr 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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 002411 MO Primary

Addresses

Primary practice location

13610 Barrett Office Dr
Suite 108
Ballwin, MO 63021-7816

Mailing address

13026 Huntercreek Rd
Des Peres, MO 63131-2229
Phone (314) 965-4419

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
Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
002411MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1750390035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13026 HUNTERCREEK RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631312229",
            "telephone_number": "314-965-4419",
            "fax_number": "314-965-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13610 BARRETT OFFICE DR",
            "address_2": "SUITE 108",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630217816",
            "telephone_number": "314-965-2559",
            "fax_number": "314-965-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRALKA",
        "first_name": "MARY",
        "middle_name": "JOSEPHA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "002411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.