Healthcare Provider Details

I. General information

NPI: 1902714421
Provider Name (Legal Business Name): JENNA LEIGH HASTINGS MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14323 S OUTER 40 RD STE 512S
TOWN AND COUNTRY MO
63017-5734
US

IV. Provider business mailing address

474 E JACKSON RD
WEBSTER GROVES MO
63119-4128
US

V. Phone/Fax

Practice location:
  • Phone: 314-325-6396
  • Fax:
Mailing address:
  • Phone: 314-648-1775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2026041836
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: