Healthcare Provider Details

I. General information

NPI: 1104374792
Provider Name (Legal Business Name): MEGGIE HUMPHREYS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SAINT PETERS CENTRE BLVD
SAINT PETERS MO
63376-1653
US

IV. Provider business mailing address

150 SAINT PETERS CENTRE BLVD
SAINT PETERS MO
63376-1653
US

V. Phone/Fax

Practice location:
  • Phone: 636-466-8497
  • Fax:
Mailing address:
  • Phone: 636-466-8497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2014031250
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: