Organization Active NPI

Mental Health Life LLC

  • Psychiatry Physician
  • Saint Peters, MO
National Provider Identifier
1780546887
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MENTAL HEALTH LIFE LLC
Practice address
4087 N Saint Peters Pkwy
Saint Peters, MO 63304-7396
Phone
(636) 775-4894
Fax
(855) 719-2526
NPI assigned
Nov 26, 2025
Last updated
Nov 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Authorized official

Name
Alexander Shaw
Title
Director of Operations
Phone
(636) 279-0847

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4087 N Saint Peters Pkwy
Saint Peters, MO 63304-7396

Mailing address

206 Candice Way
Saint Peters, MO 63376-4621
Phone (636) 775-4894

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Life LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4087 N Saint Peters Pkwy
Saint Peters, MO 63304
Phone (636) 775-4894

NPI Registry JSON

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1780546887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CANDICE WAY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764621",
            "telephone_number": "636-775-4894",
            "fax_number": "855-719-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4087 N SAINT PETERS PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633047396",
            "telephone_number": "636-775-4894",
            "fax_number": "855-719-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH LIFE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-26",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "636-279-0847"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2025; 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.