Healthcare Provider Details

I. General information

NPI: 1215629670
Provider Name (Legal Business Name): TOOLEY THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HUBER PARK CT STE 203
WELDON SPRING MO
63304-8683
US

IV. Provider business mailing address

418 LANTANA LN
SAINT PETERS MO
63376-5309
US

V. Phone/Fax

Practice location:
  • Phone: 417-289-2220
  • Fax:
Mailing address:
  • Phone: 636-233-9112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. TYLER Z TOOLEY
Title or Position: OWNER/CLINICIAN
Credential: MS, LPC
Phone: 636-233-9112