Healthcare Provider Details

I. General information

NPI: 1639008360
Provider Name (Legal Business Name): GINA GERSHILEVICH MA, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S BEMISTON AVE STE 710
CLAYTON MO
63105-1913
US

IV. Provider business mailing address

921 S HANLEY RD APT A
SAINT LOUIS MO
63105-2664
US

V. Phone/Fax

Practice location:
  • Phone: 314-325-2175
  • Fax:
Mailing address:
  • Phone: 816-562-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2025046327
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: