Active NPI
Connie S Trunk, M.ED., LPC, NCC,NBCC
- Professional Counselor
- St. Louis, MO
National Provider Identifier
1831370006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2003010622
- Practice address
- 5494 Brown Rd
Suite 110 New Beginnings Connie Trunk , LPC,NCC
St. Louis, MO 63042-1100 - Phone
- (314) 731-7667
- NPI assigned
- Nov 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2003010622 | MO | Primary |
Addresses
Primary practice location
5494 Brown Rd
Suite 110 New Beginnings Connie Trunk , LPC,NCC
St. Louis, MO 63042-1100
Mailing address
5494 Brown Rd
Suite 110
Hazelwood, MO 63042-1100
Phone (314) 731-7667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11533239 | Other | MO | CAQH ID |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2003010622 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195171200000",
"number": "1831370006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5494 BROWN RD",
"address_2": "SUITE 110",
"city": "HAZELWOOD",
"state": "MO",
"postal_code": "630421100",
"telephone_number": "314-731-7667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5494 BROWN RD",
"address_2": "SUITE 110 NEW BEGINNINGS CONNIE TRUNK , LPC,NCC",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "630421100",
"telephone_number": "314-731-7667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUNK",
"first_name": "CONNIE",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "M.ED., LPC, NCC,NBCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-16",
"last_updated": "2007-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2003010622",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID",
"identifier": "11533239",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in St. Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.