Healthcare Provider Details

I. General information

NPI: 1962310557
Provider Name (Legal Business Name): MARLEE DANIELLE BILLINGSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9734 JACKIE LN
SAINT LOUIS MO
63123-7125
US

IV. Provider business mailing address

9734 JACKIE LN
SAINT LOUIS MO
63123-7125
US

V. Phone/Fax

Practice location:
  • Phone: 573-205-7458
  • Fax:
Mailing address:
  • Phone: 573-205-7458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW00001340
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025050339
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: