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EBONY THERAPY LLC
NPI 1679173108
Social Worker - Clinical in Bridgeton, MO

Active since October 26, 2020
3751 PENNRIDGE DR STE 119, BRIDGETON, MO 63044(314) 791-2606 Get Directions Write a Review

NPPES record last updated: November 17, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 17, 2020, Oct 26, 2020 (2 updates tracked since 2020).

About Ebony Therapy Llc NPPES

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

EBONY THERAPY LLC (NPI 1679173108) is a healthcare organization registered as a clinical in Bridgeton, Missouri and active in the NPI registry since October 2020. The organization lists Clara Genine Edwards, Official Delegate, as its authorized official.

NPPES Registry Identity

NPI1679173108
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameEBONY THERAPY LLC
Location Address3751 PENNRIDGE DR STE 119Bridgeton, MO 63044-1244
Mailing Address3751 Pennridge Dr Ste 119Bridgeton, MO 63044-1244 · (314) 443-7776 · Fax (314) 735-4377
Phone(314) 791-2606
Organization SubpartNo
Authorized OfficialClara Genine EdwardsOfficial Delegate · (314) 791-2606
Enumeration DateOctober 26, 2020
Last NPPES UpdateNovember 17, 20202 updates tracked since enumeration
NPPES CertifiedNovember 17, 2020
✔ NPI 1679173108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X
3751 PENNRIDGE DR STE 119, Bridgeton, MO 63044
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Group Practice 2

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ebony Therapy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Ebony Therapy LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Ebony Hutchinson, PLCSW
Clinical Social Worker
NPI 1033253208
7401 FLORISSANT RD
Saint Louis, MO 63121
(314) 261-6011
✔ PECOS8.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebony Therapy LLC's NPI number?

The NPI number for Ebony Therapy LLC is 1679173108. It was assigned to this organization in the NPPES registry on October 26, 2020.

Where is Ebony Therapy LLC located?

Ebony Therapy LLC is located at 3751 Pennridge Dr Ste 119, Bridgeton, MO 63044. The listed phone number is (314) 791-2606.

What is Ebony Therapy LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Ebony Therapy LLC enrolled in Medicare?

Yes. Ebony Therapy LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ebony Therapy LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Ebony Therapy LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ebony Therapy LLC was last updated on November 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.