| Mindful Change Stl Llc | |
|
655 Craig Rd Ste 230 Creve Coeur MO 63141-7170 | |
| (314) 799-6899 | |
| Not Available |
| Full Name | Mindful Change Stl Llc |
|---|---|
| Speciality | Counselor |
| Location | 655 Craig Rd Ste 230, Creve Coeur, Missouri |
| Authorized Official Name and Position | Amy Beck (OWNER/THERAPIST) |
| Authorized Official Contact | 3147996899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Change Stl Llc 655 Craig Rd Ste 230 Creve Coeur MO 63141-7170 Ph: (314) 475-3444 | Mindful Change Stl Llc 655 Craig Rd Ste 230 Creve Coeur MO 63141-7170 Ph: (314) 799-6899 |
| NPI Number | 1649055526 |
|---|---|
| Provider Enumeration Date | 08/29/2023 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Medicare PECOS PAC ID | 4486004603 |
|---|---|
| Medicare Enrollment ID | O20231229000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649055526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Amy Beck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548704166 PECOS PAC ID: 5395195515 Enrollment ID: I20231229000621 |
| Provider Name | Jane Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306219563 PECOS PAC ID: 6204286420 Enrollment ID: I20231229000694 |
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