Healthcare Provider Details

I. General information

NPI: 1588598577
Provider Name (Legal Business Name): COURTENEY PARRY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11726 SAINT CHARLES ROCK RD STE A
BRIDGETON MO
63044-2631
US

IV. Provider business mailing address

11726 SAINT CHARLES ROCK RD STE A
BRIDGETON MO
63044-2631
US

V. Phone/Fax

Practice location:
  • Phone: 314-632-6354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2026022517
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: