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NPI Code Detail

MEDICARE: BLASH COUNSELING ASSOCIATES

MEDICARE: BLASH 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
1101YM0800XMental Health Counselor2015009900MO

General Provider Information

NPI Number : 1942675350
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLASH COUNSELING ASSOCIATES
Provider Business Mailing Address
First Line : 1323 SULLIVAN AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-3919
Country : US
Telephone Number : 314-503-1746
Fax Number :
Provider Business Practice Location Address
First Line : 1323 SULLIVAN AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-3919
Country : US
Telephone Number : 314-503-1746
Fax Number :
Authorized Official
Title or Position : OFFICE COORDINATOR
Name : MRS. TINA MAE BROOKS
Credential :
Telephone Number : 314-503-1746
Provider Enumeration Date : 12/10/2015
Last Update Date : 12/10/2015

Similar Medicare Providers

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Practice Fax:
1144685314 — MR. DONALD MCMURRAY PLPC
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1316392061 — ALPHONSO IVY JR. PLPC
Practice Location Address:
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Directions to “BLASH COUNSELING ASSOCIATES ” Practice Location

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