Healthcare Provider Details

I. General information

NPI: 1629190020
Provider Name (Legal Business Name): COUNSELING AND ASSESSMENT FOR BEHAVIORAL HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 CRAIG RD SUITE 318
SAINT LOUIS MO
63141-7132
US

IV. Provider business mailing address

655 CRAIG RD SUITE 318
SAINT LOUIS MO
63141-7132
US

V. Phone/Fax

Practice location:
  • Phone: 314-569-5055
  • Fax: 314-569-5075
Mailing address:
  • Phone: 314-569-5055
  • Fax: 314-569-5075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1999140257
License Number StateMO

VIII. Authorized Official

Name: DR. CATHERINE BULL HASLER
Title or Position: DIRECTOR
Credential: PHD
Phone: 314-569-5055