Healthcare Provider Details

I. General information

NPI: 1790994804
Provider Name (Legal Business Name): STEPHANIE CHRISTINE SCHULTE M.ED., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 PROSPECT AVE STE O
KIRKWOOD MO
63122-6024
US

IV. Provider business mailing address

696 VANDERVILLE DR
FENTON MO
63026-3328
US

V. Phone/Fax

Practice location:
  • Phone: 314-394-8009
  • Fax: 314-394-8141
Mailing address:
  • Phone: 314-494-0058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2004037145
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2004037145
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: