Healthcare Provider Details

I. General information

NPI: 1629993639
Provider Name (Legal Business Name): NEKTON AUTISM OF MISSOURI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4625 LINDELL BLVD STE 200
SAINT LOUIS MO
63108-3725
US

IV. Provider business mailing address

4625 LINDELL BLVD STE 200
SAINT LOUIS MO
63108-3725
US

V. Phone/Fax

Practice location:
  • Phone: 845-533-6355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: C AUSCH
Title or Position: CEO
Credential:
Phone: 845-533-6355