| Austin Wilmot, M.s.w., L.c.s.w., Llc | |
|
300 Hunter Ave Ste 125 Saint Louis MO 63124-2328 | |
| (314) 250-9500 | |
| Not Available |
| Full Name | Austin Wilmot, M.s.w., L.c.s.w., Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 300 Hunter Ave Ste 125, Saint Louis, Missouri |
| Authorized Official Name and Position | Austin Wilmot (OWNER) |
| Authorized Official Contact | 3142509500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Wilmot, M.s.w., L.c.s.w., Llc 300 Hunter Ave Ste 125 Saint Louis MO 63124-2328 Ph: (314) 250-9500 | Austin Wilmot, M.s.w., L.c.s.w., Llc 300 Hunter Ave Ste 125 Saint Louis MO 63124-2328 Ph: (314) 250-9500 |
| NPI Number | 1578125613 |
|---|---|
| Provider Enumeration Date | 06/28/2019 |
| Last Update Date | 02/03/2024 |
| Certification Date | 01/31/2024 |
| Medicare PECOS PAC ID | 9032447289 |
|---|---|
| Medicare Enrollment ID | O20190731003092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578125613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Austin E Wilmot |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407234552 PECOS PAC ID: 0547544652 Enrollment ID: I20170308001554 |
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