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General NPI Number Information
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NPI Number | 1043554934
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Entity Type | Individual
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Provider Name | ERIC JOSEPH STAPLES L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 400 S SUNSHINE ST
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City | BRANSON
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State | MO
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Zip | 65616-2518
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Country | US
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Telephone | 417-334-7437
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Fax | 417-335-2273
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Provider Business Mailing Address
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Address Line | 400 SOUTH SUNSHINE ST. FIRST BAPTIST CHURCH-BRANSON
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City | BRANSON
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State | MO
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Zip | 65616-2518
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Country | US
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Telephone | 417-334-7437
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Fax | 417-335-2273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | 2013004224
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2013004224
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License Number State | MO
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