Counseling St. Charles, LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

COUNSELING ST. CHARLES, LLC

Practice address

109 Church St
Suite 105
O Fallon, MO 63366-2894

Phone

(636) 294-0015

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Shannon Roberson, LPC

Title

Counselor

Phone

(636) 294-0015

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Counseling St Charles 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.

• Counseling St. Charles, LLC

  • Community/Behavioral Health Agency
  • O Fallon, MO
  • NPI 1316294630
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Tabak, LCSW

  • Clinical Social Worker
  • O Fallon, MO
  • NPI 1114276342
  NPD (past)

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1811248537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CHURCH ST",
            "address_2": "SUITE 105",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662894",
            "telephone_number": "636-294-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CHURCH ST",
            "address_2": "SUITE 105",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633662894",
            "telephone_number": "636-294-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING ST. CHARLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "636-294-0015",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIVISION OF PROFESSIONAL REGISTRATION",
            "identifier": "002217",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Christopher Cooper, D.C
• Cornerstone Care Management, LLC
• Corporate Surgical Arts LLC
• Christine C Cortadillo, D.O.
• Counseling St. Charles, LLC
• Cowser Spine and Sport
• Steven Michael Cowser, DC
• Shannon Marie McDermott Crandall, LCSW
• Catherine L Crass, WHNP
• Yolande J Crawford, CERT HAIRLOSS SPECIA

• Case Management Agency in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Case Management Agency in Missouri

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