Healthcare Provider Details

I. General information

NPI: 1558287698
Provider Name (Legal Business Name): GROUNDED PATH WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14137 CLAYTON RD
TOWN AND COUNTRY MO
63017-8355
US

IV. Provider business mailing address

14137 CLAYTON RD
TOWN AND COUNTRY MO
63017-8355
US

V. Phone/Fax

Practice location:
  • Phone: 314-403-0997
  • Fax:
Mailing address:
  • Phone: 314-403-0997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: HOLLIE BICKEL
Title or Position: MENTAL HEALTH COUNSELOR
Credential: PLPC, NCC
Phone: 314-683-8551