Healthcare Provider Details

I. General information

NPI: 1639708639
Provider Name (Legal Business Name): JOHN RAPP, LCSW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 BONHOMME AVE STE 416
CLAYTON MO
63105-3515
US

IV. Provider business mailing address

271 WYNSTAY AVE
VALLEY PARK MO
63088-1442
US

V. Phone/Fax

Practice location:
  • Phone: 573-424-4808
  • Fax:
Mailing address:
  • Phone: 314-456-9127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN GREGORY RAPP
Title or Position: OWNER
Credential: LCSW
Phone: 314-456-9127