Healthcare Provider Details

I. General information

NPI: 1841522307
Provider Name (Legal Business Name): LANNY WILLIAM MCFARLAND L.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 05/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11166 TESSON FERRY RD STE 203
SAINT LOUIS MO
63123-6966
US

IV. Provider business mailing address

11166 TESSON FERRY RD STE 203
SAINT LOUIS MO
63123-6966
US

V. Phone/Fax

Practice location:
  • Phone: 314-849-2120
  • Fax:
Mailing address:
  • Phone: 314-849-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCS001467
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: