Healthcare Provider Details

I. General information

NPI: 1891642328
Provider Name (Legal Business Name): NORWINE BEHAVIORAL HEALTH ADVOCATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 03/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 CLARENDON LN
ST CHARLES MO
63301
US

IV. Provider business mailing address

304 CLARENDON LN
ST CHARLES MO
63301
US

V. Phone/Fax

Practice location:
  • Phone: 314-307-6272
  • Fax:
Mailing address:
  • Phone: 314-307-6272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK DAVID NORWINE
Title or Position: PRESIDENT
Credential: LPC
Phone: 314-307-6272