Healthcare Provider Details

I. General information

NPI: 1255329272
Provider Name (Legal Business Name): LOUANN FELLERS ENGLE LCSW-QS, BCD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31ST MEDICAL GROUP/SGST UNIT 6180
APO AE
09604
IT

IV. Provider business mailing address

PSC 103 BOX 1762
APO AE
09603-0018
US

V. Phone/Fax

Practice location:
  • Phone: 314-632-5352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW19007
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: