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General NPI Number Information
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NPI Number | 1114738051
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Entity Type | Organization
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Legal Business Name | SERENDIPITY COUNSELING SAINT LOUIS
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 1001 BOARDWALK SPRINGS PL STE 111
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City | O FALLON
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State | MO
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Zip | 63368-4777
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Country | US
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Telephone | 636-352-4324
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Fax |
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Provider Business Mailing Address
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Address Line | 68 SHIRLEY DR
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City | TROY
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State | MO
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Zip | 63379-6304
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Country | US
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Telephone | 636-290-8147
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Fax |
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Authorized Official
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Title or Position | OWNER/LPC
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Name | KIMBERLY LYNN ROBERTS
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Credential | MS, LPC
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Telephone | 636-290-8147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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