| Open Gate Therapy | |
|
6220 S Lindbergh Blvd Ste 300 Saint Louis MO 63123-7839 | |
| (314) 498-7327 | |
| Not Available |
| Full Name | Open Gate Therapy |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6220 S Lindbergh Blvd Ste 300, Saint Louis, Missouri |
| Authorized Official Name and Position | Katherine C Macleod (LCSW) |
| Authorized Official Contact | 3144987327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Gate Therapy 5602 Hancock Ave Saint Louis MO 63139-1518 Ph: (314) 498-7327 | Open Gate Therapy 6220 S Lindbergh Blvd Ste 300 Saint Louis MO 63123-7839 Ph: (314) 498-7327 |
| NPI Number | 1124580501 |
|---|---|
| Provider Enumeration Date | 04/03/2019 |
| Last Update Date | 03/08/2022 |
| Certification Date | 03/08/2022 |
| Medicare PECOS PAC ID | 7810321700 |
|---|---|
| Medicare Enrollment ID | O20191231001797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124580501 | NPI | - | NPPES |
| NA | Other | MO | NA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Katherine Cameron Macleod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225575145 PECOS PAC ID: 3678836590 Enrollment ID: I20180406000395 |
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