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NPI Code Detail

MEDICARE: QIYUN GAO LCSW

MEDICARE: QIYUN GAO 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
11041C0700XClinical Social Worker2018030143MO

General Provider Information

NPI Number : 1932635299
Entity Type Code : Individual
Provider Name (Legal Business Name) : QIYUN GAO LCSW
Provider Business Mailing Address
First Line : 1507 WILD BERRY CT
Second Line :
City : BALLWIN
State : MO
Zip : 63021-7776
Country : US
Telephone Number : 812-345-8634
Fax Number :
Provider Business Practice Location Address
First Line : 1034 S BRENTWOOD BLVD STE 555
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-1265
Country : US
Telephone Number : 314-596-2448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2017
Last Update Date : 04/04/2026

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Directions to “ QIYUN GAO LCSW” Practice Location

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