Healthcare Provider Details

I. General information

NPI: 1750822714
Provider Name (Legal Business Name): CATHERINE LENZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2017
Last Update Date: 08/14/2021
Certification Date: 08/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 CLIFF CAVE RD STE 200
SAINT LOUIS MO
63129-3646
US

IV. Provider business mailing address

1650 TRINITY CIR
ARNOLD MO
63010-2647
US

V. Phone/Fax

Practice location:
  • Phone: 314-683-9105
  • Fax: 314-293-9970
Mailing address:
  • Phone: 314-535-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2014012324
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number8313
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: