Healthcare Provider Details

I. General information

NPI: 1922454552
Provider Name (Legal Business Name): SUMMIT COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1654 BRYAN RD
DARDENNE PRAIRIE MO
63368-4897
US

IV. Provider business mailing address

1654 BRYAN RD
DARDENNE PRAIRIE MO
63368-4897
US

V. Phone/Fax

Practice location:
  • Phone: 636-344-0433
  • Fax: 636-410-3336
Mailing address:
  • Phone: 636-344-0433
  • Fax: 636-410-3336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. EMILY KIRCHER MORRIS
Title or Position: LPC
Credential: M.A., M.ED.
Phone: 636-344-0433