NPIMap

Organization Active NPI

Fitzgibbons Psychological West County Psychological Associates

  • Psychologist
  • Saint Louis, MO
National Provider Identifier
1861792723
Registry record updated Apr 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00944 Issued in MO
Legal business name
FITZGIBBONS PSYCHOLOGICAL WEST COUNTY PSYCHOLOGICAL ASSOCIATES
Practice address
12125 Woodcrest Executive Dr
Saint Louis, MO 63141-5001
Phone
(314) 275-8599
NPI assigned
Oct 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2015

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

Authorized official

Name
Mrs. Mary Fitzgibbons
Title
Director
Phone
(314) 275-8599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 00944 MO Primary

Addresses

Primary practice location

12125 Woodcrest Executive Dr
Saint Louis, MO 63141-5001

Mailing address

12125 Woodcrest Executive Dr
Saint Louis, MO 63141-5001
Phone (314) 275-8599

National Provider Directory

National Provider Directory

Locations

12125 Woodcrest Executive Dr
Saint Louis, MO 63141
Phone (314) 275-8599

1215 Fern Ridge Pkwy
Ste 110
Saint Louis, MO 63141
Phone (314) 275-8599

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428969600000",
    "number": "1861792723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415001",
            "telephone_number": "314-275-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415001",
            "telephone_number": "314-275-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZGIBBONS PSYCHOLOGICAL WEST COUNTY PSYCHOLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2015-04-14",
        "status": "A",
        "authorized_official_last_name": "FITZGIBBONS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "314-275-8599",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MO",
            "license": "00944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; 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.