=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316485832
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REACH OUT CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2017
-----------------------------------------------------
Last Update Date | 02/03/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5158 SUSON WAY CT
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63128-4531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-677-8162
-----------------------------------------------------
Fax | 314-467-0909
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5158 SUSON WAY CT
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63128-4531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-677-8162
-----------------------------------------------------
Fax | 314-467-0909
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL SOCIAL WORKER
-----------------------------------------------------
Name | JANET M GALASKE
-----------------------------------------------------
Credential | MSW,LCSW
-----------------------------------------------------
Telephone | 314-677-8162
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 000226
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------