Healthcare Provider Details

I. General information

NPI: 1962312280
Provider Name (Legal Business Name): CAROLYN ELIZABETH LEMEN MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1465 S GRAND BLVD
SAINT LOUIS MO
63104-1003
US

IV. Provider business mailing address

7600 COMFORT AVE
MAPLEWOOD MO
63143-2804
US

V. Phone/Fax

Practice location:
  • Phone: 314-268-2700
  • Fax:
Mailing address:
  • Phone: 314-306-2326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number11302
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: