Healthcare Provider Details

I. General information

NPI: 1861602922
Provider Name (Legal Business Name): SARAH M. GUIDORZI MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10004 KENNERLY RD STE 280B
SAINT LOUIS MO
63128-2177
US

IV. Provider business mailing address

10004 KENNERLY RD STE 280B
SAINT LOUIS MO
63128-2177
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-7296
  • Fax: 314-525-7260
Mailing address:
  • Phone: 314-525-7296
  • Fax: 314-525-7260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004489
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: