=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366236515
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNBURDENED HEART COUNSELING & CONSULTATION, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 118 MAPLE ST UNIT 1
-----------------------------------------------------
City | EASTHAMPTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01027-1716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-303-2528
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5825 SOUTHWEST AVE APT 7
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63139-1653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-303-2528
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER AND LEAD THERAPIST
-----------------------------------------------------
Name | QUIN MARILYN RICH
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 314-303-2528
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------