Healthcare Provider Details

I. General information

NPI: 1497268361
Provider Name (Legal Business Name): ELEANORE SCHEBEK MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2017
Last Update Date: 11/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12303 DEPAUL DR
ST. LOUIS MO
63044
US

IV. Provider business mailing address

5567 CONNECTICUT ST
SAINT LOUIS MO
63139-1701
US

V. Phone/Fax

Practice location:
  • Phone: 314-344-6560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2016004685
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: