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General NPI Number Information
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NPI Number | 1164389144
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Entity Type | Organization
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Legal Business Name | MARY ADVOCACY CENTER
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 5000 N PARK DR
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City | EAST SAINT LOUIS
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State | IL
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Zip | 62204-2037
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Country | US
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Telephone | 618-979-0160
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Fax |
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Provider Business Mailing Address
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Address Line | 5000 N PARK DR
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City | EAST SAINT LOUIS
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State | IL
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Zip | 62204-2037
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Country | US
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Telephone | 618-979-0160
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY HAMIEL
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Credential |
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Telephone | 618-979-0160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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