NPIMap

Organization Active NPI

Christian Counseling and Psychological Services

  • Psychologist
  • Maryland Heights, MO
National Provider Identifier
1881861615
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY 01632 Issued in MO
Legal business name
CHRISTIAN COUNSELING AND PSYCHOLOGICAL SERVICES
Practice address
12131 Dorsett Rd
Suite 220
Maryland Heights, MO 63043-2418
Phone
(314) 298-0900
Fax
(314) 298-9274
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Mr. Hal I Pendergrass, MANPI 1073677738
Title
Psychologist
Phone
(314) 298-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY 01632 MO Primary

Addresses

Primary practice location

12131 Dorsett Rd
Suite 220
Maryland Heights, MO 63043-2418

Mailing address

12131 Dorsett Rd
Suite 220
Maryland Heights, MO 63043-2418
Phone (314) 298-0900

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1881861615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12131 DORSETT RD",
            "address_2": "SUITE 220",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432418",
            "telephone_number": "314-298-0900",
            "fax_number": "314-298-9274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12131 DORSETT RD",
            "address_2": "SUITE 220",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432418",
            "telephone_number": "314-298-0900",
            "fax_number": "314-298-9274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "PENDERGRASS",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "314-298-0900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MO",
            "license": "PY 01632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryland Heights, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.