Individual provider Active NPI

Annetta Sykes

  • Counselor
  • Saint Louis, MO
National Provider Identifier
1790934032
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2008010317 Issued in MO
Practice address
1700 Edmar LN
Saint Louis, MO 63138-1714
Phone
(314) 614-7062
Fax
(314) 473-1094
NPI assigned
Sep 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2008010317 MO Primary

Addresses

Primary practice location

1700 Edmar LN
Saint Louis, MO 63138-1714

Mailing address

1700 Edmar LN
Saint Louis, MO 63138-1714
Phone (314) 614-7062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251219002915 MO Practitioner - Mental Health Counselor 4981199619 Practice locations: Saint Louis, MO

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1700 Edmar LN
Saint Louis, MO 63138-1714
Phone (314) 219-1790

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2008010317MOMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
99Billion Better Behavior Support & Learning Center Counselor CurrentSince Sep 21, 2025 Accepting new patients
99Billion Better Behavior Support & Learning Cente CurrentSince Sep 21, 2025 Accepting new patients

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": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1790934032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 EDMAR LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381714",
            "telephone_number": "314-614-7062",
            "fax_number": "314-473-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 EDMAR LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631381714",
            "telephone_number": "314-614-7062",
            "fax_number": "314-473-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYKES",
        "first_name": "ANNETTA",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2008010317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.