Goal Driven Counseling Llc | |
1855 Chateau Du Mont Dr Florissant MO 63031-1053 | |
(314) 699-4216 | |
(949) 404-6130 |
Full Name | Goal Driven Counseling Llc |
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Speciality | Social Worker |
Location | 1855 Chateau Du Mont Dr, Florissant, Missouri |
Authorized Official Name and Position | Melissa Douglass (OWNER) |
Authorized Official Contact | 3146994216 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Goal Driven Counseling Llc Po Box 125 Florissant MO 63032-0125 Ph: (314) 699-4216 | Goal Driven Counseling Llc 1855 Chateau Du Mont Dr Florissant MO 63031-1053 Ph: (314) 699-4216 |
NPI Number | 1659842433 |
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Provider Enumeration Date | 12/05/2018 |
Last Update Date | 10/22/2020 |
Certification Date | 10/22/2020 |
Medicare PECOS PAC ID | 7517290372 |
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Medicare Enrollment ID | O20190610002300 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659842433 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Melissa D Douglass |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164968772 PECOS PAC ID: 0244563005 Enrollment ID: I20190610002379 |
Provider Name | Joni L Chester |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1881151983 PECOS PAC ID: 3476987348 Enrollment ID: I20191231000849 |
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