Healthcare Provider Details

I. General information

NPI: 1023768413
Provider Name (Legal Business Name): ROBYN BOOKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BEHAVIORAL HEALTH RESPONSE 5501 DELMAR SUITE B300
ST. LOUIS MO
63112
US

IV. Provider business mailing address

439 S CLAY AVE APT 1
KIRKWOOD MO
63122-5840
US

V. Phone/Fax

Practice location:
  • Phone: 636-497-2983
  • Fax:
Mailing address:
  • Phone: 636-497-2983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2018039323
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: