JENNIFER WALLACE EBELING MA, LPC
NPI 1104393040
Counselor - Professional in Saint Louis, MO

Q: What is Jennifer Ebeling's NPI number?

The NPI number for Jennifer Ebeling is 1104393040. It was assigned to this individual provider in the NPPES registry on October 29, 2018.

Q: What is Jennifer Ebeling's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Ebeling was last updated on September 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 29, 2018PECOS Enrolled

1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103(314) 206-3700 Get Directions Write a Review

NPPES record last updated: September 29, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 29, 2022, Oct 29, 2018 (2 updates tracked since 2018).

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About Jennifer Wallace Ebeling Ma, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER WALLACE EBELING MA, LPC (NPI 1104393040) is an individual professional provider in Saint Louis, Missouri, licensed in Missouri (2017018577) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1104393040

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameJENNIFER WALLACE EBELINGCredential: MA, LPC

Location Address1430 OLIVE ST STE 400Saint Louis, MO 63103-2303

Mailing Address1430 Olive St Ste 400Saint Louis, MO 63103-2303 · (314) 206-3700

Phone(314) 206-3700

Sole ProprietorNo

Medical School CMSOtherGraduated 1992

Enumeration DateOctober 29, 2018

Last NPPES UpdateSeptember 29, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 29, 2022

✔ NPI 1104393040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MO · 2017018577

1430 OLIVE ST STE 400, Saint Louis, MO 63103

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Other Identifiers 1

Other2017018577MO · Lpc

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Wallace Ebeling Ma, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214492479

PECOS Enrollment IDI20260720000420

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NATALIE ANN SOUCY LPC

Counselor (Mental Health)