Healthcare Provider Details

I. General information

NPI: 1457072167
Provider Name (Legal Business Name): ALENA ARMSTEAD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 08/31/2024
Certification Date: 08/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 KRATKY RD STE 100
SAINT LOUIS MO
63114-1706
US

IV. Provider business mailing address

2122 KRATKY RD STE 100
SAINT LOUIS MO
63114-1706
US

V. Phone/Fax

Practice location:
  • Phone: 314-252-8216
  • Fax: 844-519-7811
Mailing address:
  • Phone: 314-252-8216
  • Fax: 844-519-7811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2023016203
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: