Active NPI
Noah Lyles PHD MFT, PHD MFT
- Professional Counselor
- Clayton, MO
National Provider Identifier
1912485657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2009000351
- Practice address
- 8112 Maryland Ave
Clayton, MO 63105-3729 - Phone
- (314) 474-9475
- NPI assigned
- Aug 3, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 2009000351 | MO | |
| Pastoral Counselor | 101YP1600X | 0089565 | TN | |
| Professional Counselor | 101YP2500X | 0089565 | TN | |
| Professional Counselor | 101YP2500X | 2009000351 | MO | Primary |
Addresses
Primary practice location
8112 Maryland Ave
Clayton, MO 63105-3729
Mailing address
8112 Maryland Ave
Clayton, MO 63105-3729
Phone (314) 449-3648
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85-2660293 | Other | MO | MEDICAL BILLING |
| 85-2660293 | Medicaid | MO | |
| 831317927 | Medicaid | TN |
Electronic endpoints 8
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | info@unitedcccenter.com | Direct | United Christian Counseling Service LLC |
| CONNECT URL | unitedcccenter.com | Health Information Exchange (HIE) | United Christian Counseling Service LLC |
| Other URL | outlook.com | Direct | Lifeway Family Service |
| CONNECT URL | info@unitedcccenter.com | Health Information Exchange (HIE) | United Health Care |
| Direct Messaging Address | noah.lyles@unitedcccenter.com | Health Information Exchange (HIE) | Agape Counseling Services |
| CONNECT URL | noah.lyles@unitedcccenter.com | Health Information Exchange (HIE) | Centerstone of Illinois, Inc |
| CONNECT URL | noah.lyles@unitedcccenter.com | Direct | Centerstone of Tennesse Inc. |
| CONNECT URL | unitedcccenter.com | Health Information Exchange (HIE) | United Health Care Services |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009000351 | MO | MD | Pastoral Counselor |
| 0089565 | TN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noah Henderson PHD MFT | Current | Accepting new patients |
Locations
7733 Forsyth Blvd
Fl 11
Saint Louis, MO 63105
Phone (314) 296-6199
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Marriage & Family Therapist
- Saint Louis, MO
- NPI 1225641673
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1912485657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8112 MARYLAND AVE",
"city": "CLAYTON",
"state": "MO",
"postal_code": "631053729",
"telephone_number": "314-449-3648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8112 MARYLAND AVE",
"city": "CLAYTON",
"state": "MO",
"postal_code": "631053729",
"telephone_number": "314-474-9475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYLES PHD MFT",
"first_name": "NOAH",
"name_prefix": "Dr.",
"credential": "PHD MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-03",
"last_updated": "2021-11-23",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "MO",
"license": "2009000351",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "TN",
"license": "0089565",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "0089565",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2009000351",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL BILLING",
"identifier": "85-2660293",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "85-2660293",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "831317927",
"state": "TN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "info@unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Information Contact",
"affiliationName": "United Christian Counseling Service LLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7733 Forsyth Blvd",
"city": "Clayton",
"state": "MO",
"country_code": "US",
"postal_code": "631051817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Website",
"affiliationName": "United Christian Counseling Service LLC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7733 Forsyth Blvd",
"city": "Clayton",
"state": "MO",
"country_code": "US",
"postal_code": "631051817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "outlook.com",
"affiliation": "Y",
"endpointDescription": "Buisness Email",
"affiliationName": "Lifeway Family Service",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Buisness",
"address_1": "120 Cinema Dr",
"city": "Hendersonville",
"state": "TN",
"country_code": "US",
"postal_code": "370756373",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "info@unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Information Contact",
"affiliationName": "United Health Care",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7733 Forsyth Blvd",
"city": "Clayton",
"state": "MO",
"country_code": "US",
"postal_code": "631051817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "noah.lyles@unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Email",
"affiliationName": "Agape Counseling Services",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "6868 N Socrum Loop Rd",
"city": "Lakeland",
"state": "FL",
"country_code": "US",
"postal_code": "338094101",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "noah.lyles@unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Email",
"affiliationName": "Centerstone of Illinois, Inc",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2411 S Illinois Ave",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629035913",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "noah.lyles@unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Email",
"affiliationName": "Centerstone of Tennesse Inc.",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7733 Forsyth Blvd",
"city": "Clayton",
"state": "MO",
"country_code": "US",
"postal_code": "631051817",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "unitedcccenter.com",
"affiliation": "Y",
"endpointDescription": "Website",
"affiliationName": "United Health Care Services",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "7733 Forsyth Blvd",
"city": "Clayton",
"state": "MO",
"country_code": "US",
"postal_code": "631051817",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clayton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.