Healthcare Provider Details

I. General information

NPI: 1477823227
Provider Name (Legal Business Name): KAREN GRAYSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2012
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 THE PINES CT STE B
SAINT LOUIS MO
63141-6081
US

IV. Provider business mailing address

3860 JUNIATA ST
SAINT LOUIS MO
63116-4814
US

V. Phone/Fax

Practice location:
  • Phone: 314-750-3881
  • Fax:
Mailing address:
  • Phone: 314-750-3881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2009017144
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: