Healthcare Provider Details

I. General information

NPI: 1104106400
Provider Name (Legal Business Name): LSS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 CRAIG RD SUITE 206
CREVE COEUR MO
63141-7160
US

IV. Provider business mailing address

745 CRAIG RD STE 206
CREVE COEUR MO
63141-7122
US

V. Phone/Fax

Practice location:
  • Phone: 314-409-2362
  • Fax: 314-432-7500
Mailing address:
  • Phone: 314-409-2362
  • Fax: 314-432-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001749
License Number StateMO

VIII. Authorized Official

Name: MRS. LUANN SPENCER-STEELE
Title or Position: COUNSELOR
Credential:
Phone: 314-409-2362