| Counseling St. Charles, Llc | |
|
225 S Main St Ste 103 O Fallon MO 63366-2866 | |
| (636) 294-0015 | |
| Not Available |
| Full Name | Counseling St. Charles, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 225 S Main St, O Fallon, Missouri |
| Authorized Official Name and Position | Shannon Roberson (OWNER) |
| Authorized Official Contact | 6362940015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling St. Charles, Llc Po Box 486 O Fallon MO 63366-0486 Ph: (636) 294-0015 | Counseling St. Charles, Llc 225 S Main St Ste 103 O Fallon MO 63366-2866 Ph: (636) 294-0015 |
| NPI Number | 1316294630 |
|---|---|
| Provider Enumeration Date | 08/06/2012 |
| Last Update Date | 08/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316294630 | NPI | - | NPPES |
| 1093015257 | Other | MO | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2010012405 (Missouri) | Primary |
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