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General NPI Number Information
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NPI Number | 1124566237
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Entity Type | Individual
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Provider Name | PATRICIA ANN CULBERTSON MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 12601 MO-21
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City | DE SOTO
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State | MO
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Zip | 63020-3315
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Country | US
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Telephone | 636-535-7472
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Fax | 888-474-0821
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Provider Business Mailing Address
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Address Line | 104 HICKORY LN
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City | FESTUS
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State | MO
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Zip | 63028-3338
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Country | US
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Telephone | 636-535-7472
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Fax | 888-474-0821
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2019043830
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License Number State | MO
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