Healthcare Provider Details

I. General information

NPI: 1346348547
Provider Name (Legal Business Name): HSIN-HSIN HUANG PHD, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 OLIVE BLVD SUITE 205
SAINT LOUIS MO
63141-5454
US

IV. Provider business mailing address

12400 OLIVE BLVD SUITE 205
SAINT LOUIS MO
63141-5454
US

V. Phone/Fax

Practice location:
  • Phone: 314-249-6813
  • Fax: 314-275-2301
Mailing address:
  • Phone: 314-249-6813
  • Fax: 314-275-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2002012585
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: