Healthcare Provider Details

I. General information

NPI: 1790001139
Provider Name (Legal Business Name): AMARANTH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E BOONESLICK RD
WARRENTON MO
63383-2006
US

IV. Provider business mailing address

21209 OAK TRL
WARRENTON MO
63383-3020
US

V. Phone/Fax

Practice location:
  • Phone: 636-578-2836
  • Fax: 877-433-3107
Mailing address:
  • Phone: 636-578-2836
  • Fax: 877-433-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2010010537
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2010010537
License Number StateMO

VIII. Authorized Official

Name: PATRICKA CALDERA
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 636-578-2836