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General NPI Number Information
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NPI Number | 1245180314
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Entity Type | Organization
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Legal Business Name | SENDEROS PSYCHOTHERAPY SERVICES LLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1825 CREEKSIDE DR
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City | SWANSEA
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State | IL
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Zip | 62226-8509
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Country | US
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Telephone | 636-445-2276
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Fax |
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Provider Business Mailing Address
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Address Line | 423 S ELGIN ST
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City | JACKSONVILLE
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State | MO
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Zip | 65260-3164
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Country | US
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Telephone | 636-445-2276
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | SERGIO CHAPMAN
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Credential |
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Telephone | 636-445-2276
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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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