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General NPI Number Information
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NPI Number | 1295359354
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Entity Type | Individual
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Provider Name | AMY MARIE GOLDSTEIN MA, LPC, CSAM, CSAT
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Gender | Female
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 9666 OLIVE BLVD STE 370
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City | SAINT LOUIS
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State | MO
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Zip | 63132-3025
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Country | US
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Telephone | 636-577-2397
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Fax |
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Provider Business Mailing Address
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Address Line | 9666 OLIVE BLVD SUITE 370
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City | CREVE COEUR
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State | MO
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Zip | 63132-3000
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Country | US
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Telephone | 636-577-2397
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2020010969
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License Number State | MO
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