Healthcare Provider Details

I. General information

NPI: 1548691355
Provider Name (Legal Business Name): LORI ANN AUL M.A., PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 WATSON RD SUITE 1-L-3
SAINT LOUIS MO
63126-1854
US

IV. Provider business mailing address

10000 WATSON RD SUITE 1-L-3
SAINT LOUIS MO
63126-1854
US

V. Phone/Fax

Practice location:
  • Phone: 314-394-1935
  • Fax: 314-394-1937
Mailing address:
  • Phone: 314-394-1935
  • Fax: 314-394-1937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number2013042459
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2013042459
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2013042459
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2013042459
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: