Healthcare Provider Details

I. General information

NPI: 1255737383
Provider Name (Legal Business Name): EMILY WEBB MA, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3906 S OLD HIGHWAY 94
SAINT CHARLES MO
63304-2853
US

IV. Provider business mailing address

12184 FLEETWOOD PL
MARYLAND HEIGHTS MO
63043-1118
US

V. Phone/Fax

Practice location:
  • Phone: 314-249-0663
  • Fax:
Mailing address:
  • Phone: 314-249-0663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2014030358
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2014030358
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2014030358
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number2014030358
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number2014030358
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: