MEDICARE: EMILY PRICE LCSW

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
1	1041C0700X	Clinical Social Worker	2016033432	MO
2	1041C0700X	Clinical Social Worker	149.022466	IL
3	1041C0700X	Clinical Social Worker	2019044559	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285145367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY PRICE LCSW

Provider Business Mailing Address
First Line	:	3800 PARK AVE FL 2
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2514
Country	:	US
Telephone Number	:	314-268-2700
Fax Number	:	314-268-4028

Provider Business Practice Location Address
First Line	:	3800 PARK AVE FL 2
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2514
Country	:	US
Telephone Number	:	314-268-2700
Fax Number	:	314-268-4028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	12/10/2020

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Directions to “ EMILY PRICE LCSW” Practice Location

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