Deanna Joyce Elizabeth Self, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2008002253 Issued in MO

Practice address

1000 Lake Saint Louis Blvd
Suite Number 250
Lake Saint Louis, MO 63367-1340

Phone

(314) 570-5960

NPI assigned

Aug 15, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1952855363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKE SAINT LOUIS BLVD",
            "address_2": "SUITE NUMBER 250",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671340",
            "telephone_number": "314-570-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKE SAINT LOUIS BLVD",
            "address_2": "SUITE NUMBER 250",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671340",
            "telephone_number": "314-570-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "DEANNA",
        "middle_name": "JOYCE ELIZABETH",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2008002253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Lake Saint Louis, MO
• Providers in Lake Saint Louis, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; 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.