Healthcare Provider Details

I. General information

NPI: 1639477177
Provider Name (Legal Business Name): BRIANNE ELIZABETH SERDAR MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 MARSHALL AVE STE 2
WEBSTER GROVES MO
63119-1827
US

IV. Provider business mailing address

357 MARSHALL AVE STE 2
WEBSTER GROVES MO
63119-1827
US

V. Phone/Fax

Practice location:
  • Phone: 314-254-3378
  • Fax:
Mailing address:
  • Phone: 314-254-3378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2009007769
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: