=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104106400
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LSS COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2011
-----------------------------------------------------
Last Update Date | 10/16/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 745 CRAIG RD SUITE 206
-----------------------------------------------------
City | CREVE COEUR
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-7160
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-409-2362
-----------------------------------------------------
Fax | 314-432-7500
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 745 CRAIG RD STE 206
-----------------------------------------------------
City | CREVE COEUR
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63141-7122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-409-2362
-----------------------------------------------------
Fax | 314-432-7500
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNSELOR
-----------------------------------------------------
Name | MRS. LUANN SPENCER-STEELE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 314-409-2362
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 001749
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------