Active NPI
Mary C Obowa, LPC
- Pastoral Counselor
- Saint Louis, MO
National Provider Identifier
1902893589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 12141 Ladue Rd
Saint Louis, MO 63141-8120 - Phone
- (314) 336-1097
- Fax
- (314) 878-4524
- NPI assigned
- Sep 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | Primary | ||
| Professional Counselor | 101YP2500X | CS001545 | MO |
Addresses
Primary practice location
12141 Ladue Rd
Saint Louis, MO 63141-8120
Mailing address
12141 Ladue Rd
Saint Louis, MO 63141-8120
Phone (314) 336-1097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118671 | Other | MO | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| CS001545 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1902893589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12141 LADUE RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418120",
"telephone_number": "314-336-1097",
"fax_number": "314-878-4524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12141 LADUE RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418120",
"telephone_number": "314-336-1097",
"fax_number": "314-878-4524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBOWA",
"first_name": "MARY",
"middle_name": "C",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-29",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "CS001545",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "118671",
"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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.