MEDICARE: TOWER GROVE COUNSELING ASSOCIATES

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1558221903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWER GROVE COUNSELING ASSOCIATES

Provider Business Mailing Address
First Line	:	3832 UTAH PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-4833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3892 WYOMING ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63116-4841
Country	:	US
Telephone Number	:	636-578-4781
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONDRA AGOVINO
Credential	:
Telephone Number	:	636-578-4781

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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