Healthcare Provider Details

I. General information

NPI: 1568945020
Provider Name (Legal Business Name): VICTORIA NOELLE GRIESENAUER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA NOELLE BAILEY LCSW

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12141 LADUE RD
SAINT LOUIS MO
63141-8120
US

IV. Provider business mailing address

2650 OLIVE ST
SAINT LOUIS MO
63103-1489
US

V. Phone/Fax

Practice location:
  • Phone: 314-533-8200
  • Fax: 314-842-2552
Mailing address:
  • Phone: 314-371-6500
  • Fax: 314-371-6508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2020012928
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: