Individual provider Active NPI

Kaitlin Renee Pennington, PLPC

  • Professional Counselor
  • Saint Charles, MO
National Provider Identifier
1831782507
Registry record updated Feb 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2021005286 Issued in MO
Practice address
1722 Barbara Dr
Saint Charles, MO 63303-4004
Phone
(618) 694-4088
NPI assigned
Feb 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2021

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 2021005286 MO Primary

Addresses

Primary practice location

1722 Barbara Dr
Saint Charles, MO 63303-4004

Mailing address

1722 Barbara Dr
Saint Charles, MO 63303-4004
Phone (618) 694-4088

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
I20240612001222 MO Practitioner - Mental Health Counselor 2264974732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC CurrentSince May 6, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

255 Spencer Rd
Ste 101
Saint Peters, MO 63376
Phone (636) 477-6111

5301 Veterans Memorial Pkwy
Ste 105
Saint Peters, MO 63376
Phone (314) 806-1770

255 Spencer Rd
Ste 201
Saint Peters, MO 63376
Phone (636) 929-2550

255 Spencer Rd
Ste 101102
Saint Peters, MO 63376

Organizations & group practices 1

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": "1613260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613260800000",
    "number": "1831782507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 BARBARA DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034004",
            "telephone_number": "618-694-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 BARBARA DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034004",
            "telephone_number": "618-694-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "KAITLIN",
        "middle_name": "RENEE",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-14",
        "last_updated": "2021-02-14",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2021005286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

Verify at the official NPI Registry.