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NPI Code Detail

MEDICARE: DR. NANCY MARY FAWCETT PH.D.

MEDICARE: DR. NANCY MARY FAWCETT PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor000932MO
2101YP2500XProfessional Counselor000932MO

General Provider Information

NPI Number : 1245474600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY MARY FAWCETT PH.D.
Provider Business Mailing Address
First Line : 12141 LADUE RD
Second Line :
City : CREVE COEUR
State : MO
Zip : 63141-8120
Country : US
Telephone Number : 314-878-4340
Fax Number :
Provider Business Practice Location Address
First Line : 12141 LADUE RD
Second Line :
City : CREVE COEUR
State : MO
Zip : 63141-8120
Country : US
Telephone Number : 314-878-4340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 05/03/2026

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