NPIMap

Organization Active NPI

Elephant Rock Counseling, LLC

  • Mental Health Counselor
  • Kirkwood, MO
National Provider Identifier
1962004564
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ELEPHANT ROCK COUNSELING, LLC
Practice address
140 Prospect Ave Ste T
Kirkwood, MO 63122-6024
Phone
(314) 200-4482
NPI assigned
Nov 10, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Authorized official

Name
Chad R Randall, M.ED., LPC, CCDP-DNPI 1811134190
Title
Owner/Therapist
Phone
(314) 200-4482

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

140 Prospect Ave Ste T
Kirkwood, MO 63122-6024

Mailing address

140 Prospect Ave Ste T
Kirkwood, MO 63122-6024
Phone (314) 200-4482

Other practice location 1

10733 Big Bend Rd Ste 142
Kirkwood, MO 63122-6071
Phone (314) 200-4482

Other practice location 2

10733 Big Bend Rd Ste 141
Kirkwood, MO 63122-6071
Phone (314) 200-4482

National Provider Directory

National Provider Directory

Locations

10733 Big Bend Rd
Ste 142
Kirkwood, MO 63122
Phone (314) 200-4482

140 Prospect Ave
Ste T
Kirkwood, MO 63122
Phone (314) 200-4482

10733 Big Bend Rd
Ste 141
Kirkwood, MO 63122
Phone (314) 200-4482

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": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605052800000",
    "number": "1962004564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE STE T",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226024",
            "telephone_number": "314-200-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PROSPECT AVE STE T",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226024",
            "telephone_number": "314-200-4482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10733 Big Bend Rd Ste 142",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631226071",
            "country_code": "US",
            "telephone_number": "314-200-4482",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10733 Big Bend Rd Ste 141",
            "address_purpose": "LOCATION",
            "city": "Kirkwood",
            "state": "MO",
            "postal_code": "631226071",
            "country_code": "US",
            "telephone_number": "314-200-4482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELEPHANT ROCK COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "314-200-4482",
        "authorized_official_credential": "M.ED., LPC, CCDP-D"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; 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.