Active NPI
Rebecca Diane Poindexter, LPC
- Professional Counselor
- Saint Louis, MO
National Provider Identifier
1871006957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2017036053
- Practice address
- 11155 Dunn Rd
Saint Louis, MO 63136-6150 - Phone
- (314) 953-8101
- Fax
- (314) 953-8150
- NPI assigned
- Nov 10, 2017
- 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 | 2017036053 | MO | Primary |
Addresses
Primary practice location
11155 Dunn Rd
Saint Louis, MO 63136-6150
Mailing address
45 Dry Branch CT
Wentzville, MO 63385-4148
Phone (636) 290-6045
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017036053 | Medicaid | MO |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017036053 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510272000000",
"number": "1871006957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 DRY BRANCH CT",
"city": "WENTZVILLE",
"state": "MO",
"postal_code": "633854148",
"telephone_number": "636-290-6045",
"fax_number": "314-953-8150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11155 DUNN RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631366150",
"telephone_number": "314-953-8101",
"fax_number": "314-953-8150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POINDEXTER",
"first_name": "REBECCA",
"middle_name": "DIANE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-10",
"last_updated": "2017-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2017036053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2017036053",
"state": "MO"
}
],
"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 Nov 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.