Healthcare Provider Details

I. General information

NPI: 1760923411
Provider Name (Legal Business Name): ANGELA NARSH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2017
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N CLAY AVE STE 200
KIRKWOOD MO
63122-4265
US

IV. Provider business mailing address

7610 RANNELLS AVE
MAPLEWOOD MO
63143-1910
US

V. Phone/Fax

Practice location:
  • Phone: 314-827-5544
  • Fax:
Mailing address:
  • Phone: 314-827-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2012011830
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2012011830
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: