| Sojourn Therapy Outreach Llc | |
|
9666 Olive Blvd Ste 330 Saint Louis MO 63132-3035 | |
| (314) 399-4823 | |
| Not Available |
| Full Name | Sojourn Therapy Outreach Llc |
|---|---|
| Speciality | Social Worker |
| Location | 9666 Olive Blvd Ste 330, Saint Louis, Missouri |
| Authorized Official Name and Position | Shelly L Byndom (THERAPIST/OWNE) |
| Authorized Official Contact | 3143994823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sojourn Therapy Outreach Llc 9666 Olive Blvd Ste 330 Olivette MO 63132-3035 Ph: (314) 399-4823 | Sojourn Therapy Outreach Llc 9666 Olive Blvd Ste 330 Saint Louis MO 63132-3035 Ph: (314) 399-4823 |
| NPI Number | 1679121529 |
|---|---|
| Provider Enumeration Date | 09/03/2019 |
| Last Update Date | 09/23/2019 |
| Medicare PECOS PAC ID | 4486069697 |
|---|---|
| Medicare Enrollment ID | O20210222001970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679121529 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shelly Lynne Byndom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841444775 PECOS PAC ID: 3476795428 Enrollment ID: I20210222002067 |
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