Healthcare Provider Details
I. General information
NPI: 1407990062
Provider Name (Legal Business Name): CHILDREN'S ADVOCACY SERVICES OF GREATER ST. LOUIS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 UNIVERSITY BLVD
SAINT LOUIS MO
63121-4400
US
IV. Provider business mailing address
1 UNIVERSITY BLVD
SAINT LOUIS MO
63121-4400
US
V. Phone/Fax
- Phone: 314-516-6798
- Fax:
- Phone: 314-516-6798
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JERRY
H
DUNN
Title or Position: EXECUTIVE DIRECTOR
Credential: PH.D.
Phone: 314-516-6798