OrganizationActive
Provident
NPI 1316005473 · Preferred Provider Organization · Arnold, MO
Provider details
- NPI number
- 1316005473
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Kristin Bulin, Director of Counseling Division(314) 371-6500
- License
- 002589 (MO)
Specialties & taxonomies
Managed Care Organizations
Agencies
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3675 W Outer Rd
203
Arnold, MO 63010-5232
Phone: (314) 898-0102
Fax: (636) 296-3249
Street-level locationGet directions
Mailing address
3675 W Outer Rd
Arnold, MO 63010-5232
Registry dates
- Enumerated
- 2006-12-04
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.