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General NPI Number Information
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NPI Number | 1235398132
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Entity Type | Individual
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Provider Name | STEVEN PHILLIP MISHKIN L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 655 CRAIG RD STE 320
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7171
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Country | US
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Telephone | 314-692-4231
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Fax | 314-692-4231
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Provider Business Mailing Address
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Address Line | 10847 CHASE PARK LN APT C
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City | SAINT LOUIS
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State | MO
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Zip | 63141-5732
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Country | US
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Telephone | 314-692-4231
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Fax | 314-692-4231
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2006003954
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License Number State | MO
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