VINE LIFE COUNSELING (NPI# 1104382118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104382118 |
Entity Type | Organization |
Organization Name | VINE LIFE COUNSELING |
Practice Address |
2310 S Grand Blvd Saint Louis MO 63104-1702 |
Practice Telephone | 3144204733 |
Mailing Telephone | 3144204733 |
Enumeration Date | 2019-02-14 |
Last Update Date | 2019-02-14 |
Authorized Official Name | MR. ALPHONSO IVY JR. (OWNER COUNSELOR) |
Authorized Official Telephone | 3144204733 |
Authorized Official Credential | LPC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | Agencies |
Street Address |
2310 S GRAND BLVD |
City | SAINT LOUIS |
State | MO |
Zip Code | 63104-1702 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
Find all providers in zip 63104 |
Taxonomy Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790398329 | Walking Each Other Home Wellness LLC | Community/Behavioral Health | 5149 Dresden Ave, Saint Louis, MO 63116-1325 | 2020-08-24 |
1487271839 | Irma Hagarty Counseling Services LLC | Community/Behavioral Health | 9450 Manchester Rd Ste 204, Saint Louis, MO 63119-1452 | 2020-07-01 |
1891326559 | Justin Jerome Phillips | Community/Behavioral Health | 4021 Laclede Ave # 23211, Saint Louis, MO 63108-3271 | 2020-01-31 |
1508422858 | Patient Advocacy and Education | Community/Behavioral Health | 7006 Woodbridge Creek Ct, Saint Louis, MO 63129-6419 | 2019-05-13 |
1154985711 | Chads Coalition for Mental Health | Community/Behavioral Health | 4121 Union Rd Ste 224, Saint Louis, MO 63129-1070 | 2019-04-29 |
1831663848 | Latitude Therapy Solutions LLC | Community/Behavioral Health | 8130 Balson Ave, Saint Louis, MO 63130-3607 | 2019-01-14 |
1700376423 | Bell Therapeutic Services | Community/Behavioral Health | 4125 Humphrey St, Saint Louis, MO 63116-3824 | 2018-05-17 |
1568990505 | Tyree Edward Miller Behavioral Health Services | Community/Behavioral Health | 2829 Gainsboro Ct, Saint Louis, MO 63121-4717 | 2017-06-02 |
1316485832 | Reach Out Consulting LLC | Community/Behavioral Health | 5158 Suson Way Ct, Saint Louis, MO 63128-4531 | 2017-02-03 |
1073064523 | Hunts Haven Home Care LLC | Community/Behavioral Health | 2510 Ada Ave, Saint Louis, MO 63136-1307 | 2016-10-19 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63104 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.