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NPI Code Detail

MEDICARE: CHANGES THERAPEUTICS SERVICES

MEDICARE: CHANGES THERAPEUTICS SERVICES
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
1103TP2701XGroup Psychotherapy Psychologist

General Provider Information

NPI Number : 1417510934
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHANGES THERAPEUTICS SERVICES
Provider Business Mailing Address
First Line : 523 SAPPHIRE DR
Second Line :
City : O FALLON
State : MO
Zip : 63366-1889
Country : US
Telephone Number : 314-368-2409
Fax Number : 314-442-4139
Provider Business Practice Location Address
First Line : 12 FEE FEE RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2729
Country : US
Telephone Number : 314-368-8920
Fax Number : 314-442-4139
Authorized Official
Title or Position : OWNER/THERAPIST
Name : DR. LINDA L PETERSON
Credential : PHD
Telephone Number : 314-368-2409
Provider Enumeration Date : 04/19/2019
Last Update Date : 09/02/2025

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Directions to “CHANGES THERAPEUTICS SERVICES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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