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General NPI Number Information
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NPI Number | 1164313599
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Entity Type | Organization
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Legal Business Name | GATEWAY TO HEAL COUNSELING, LLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 3109 S GRAND BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63118-1039
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Country | US
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Telephone | 205-913-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 4208 SHENANDOAH AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63110-3513
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Country | US
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Telephone | 205-913-3050
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | AMY LYONS BURKE
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Credential | LPC
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Telephone | 205-913-3050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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