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General NPI Number Information
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NPI Number | 1255003000
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Entity Type | Organization
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Legal Business Name | OSAGE VALLEY COUNSELING LLC
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1736 WESTPARK CTR DR STE 100
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City | FENTON
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State | MO
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Zip | 63026-1916
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Country | US
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Telephone | 636-600-0446
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Fax | 636-660-2262
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Provider Business Mailing Address
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Address Line | 1736 WESTPARK CTR DR STE 100
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City | FENTON
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State | MO
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Zip | 63026-1916
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Country | US
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Telephone | 636-600-0446
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Fax | 636-660-2262
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MIRRANDA CARDINALI
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Credential | LPC, CRC
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Telephone | 636-600-0446
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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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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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