=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134720329
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COME AS YOU ARE COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2020
-----------------------------------------------------
Last Update Date | 11/04/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1001 BOARDWALK SPRINGS PLACE, SUITE 111
-----------------------------------------------------
City | O FALLON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-328-4702
-----------------------------------------------------
Fax | 636-766-2901
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1001 BOARDWALK SPRINGS PLACE, SUITE 111
-----------------------------------------------------
City | O FALLON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63368
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-328-4702
-----------------------------------------------------
Fax | 636-766-2901
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JESSICA VOGLER
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 314-328-4702
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------