Healthcare Provider Details

I. General information

NPI: 1679832810
Provider Name (Legal Business Name): KRISTA KAY REMI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9666 OLIVE BLVD STE 330
OLIVETTE MO
63132-3035
US

IV. Provider business mailing address

9666 OLIVE BLVD STE 330
OLIVETTE MO
63132-3035
US

V. Phone/Fax

Practice location:
  • Phone: 314-275-0810
  • Fax: 314-991-0100
Mailing address:
  • Phone: 314-275-0810
  • Fax: 314-991-0100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2011039353
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2011039353
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: