Healthcare Provider Details

I. General information

NPI: 1487818498
Provider Name (Legal Business Name): TERI R. MCCARTHY RN,MSW,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERI LEE RIEHL RN, MSW, LCSW

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 OLD FRONTENAC SQ SUITE 201
SAINT LOUIS MO
63131-2754
US

IV. Provider business mailing address

745 OLD FRONTENAC SQ SUITE 201
SAINT LOUIS MO
63131-2754
US

V. Phone/Fax

Practice location:
  • Phone: 314-707-7663
  • Fax: 314-721-6863
Mailing address:
  • Phone: 314-707-7663
  • Fax: 314-721-6863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW001783
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: