MEDICARE: DYLAN GURRERA LMSW

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	104100000X	Social Worker	2025047376	MO

General Provider Information

NPI Number	:	1588524557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DYLAN GURRERA LMSW

Provider Business Mailing Address
First Line	:	4144 LINDELL BLVD STE 319
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2953
Country	:	US
Telephone Number	:	314-449-1145
Fax Number	:

Provider Business Practice Location Address
First Line	:	4144 LINDELL BLVD STE 319
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-2953
Country	:	US
Telephone Number	:	314-449-1145
Fax Number	:

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

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	05/20/2026

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Directions to “ DYLAN GURRERA LMSW” Practice Location

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