Individual provider Active NPI

Susan Emily Melaragno, M.ED., LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1750512786
Registry record updated Aug 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2005038605 Issued in MO
Practice address
12400 Olive Blvd
Suite 205
Saint Louis, MO 63141-5454
Phone
(636) 675-0974
Fax
(314) 275-2301
NPI assigned
Aug 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2009

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 2005038605 MO Primary

Addresses

Primary practice location

12400 Olive Blvd
Suite 205
Saint Louis, MO 63141-5454

Mailing address

12400 Olive Blvd
Suite 205
Saint Louis, MO 63141-5454
Phone (636) 675-0974

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 Education

State licenses

LicenseStateTypeSpecialty
2005038605MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1249689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249689600000",
    "number": "1750512786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12400 OLIVE BLVD",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415454",
            "telephone_number": "636-675-0974",
            "fax_number": "314-275-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 OLIVE BLVD",
            "address_2": "SUITE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415454",
            "telephone_number": "636-675-0974",
            "fax_number": "314-275-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELARAGNO",
        "first_name": "SUSAN",
        "middle_name": "EMILY",
        "credential": "M.ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-08",
        "last_updated": "2009-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2005038605",
            "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 Aug 8, 2009; 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.