Individual provider Active NPI

Rebecca Diane Poindexter, LPC

  • Professional Counselor
  • Saint Louis, MO
National Provider Identifier
1871006957
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2017036053 Issued in MO
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

Updated by the provider on Nov 10, 2017

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 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

IdentifierTypeStateIssuer
2017036053MedicaidMO

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

LicenseStateTypeSpecialty
2017036053MOMDProfessional 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.

Verify at the official NPI Registry.