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General NPI Number Information
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NPI Number | 1356015671
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Entity Type | Individual
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Provider Name | ANTHONY CHAMBERS M.ED., BCBA
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Gender | Male
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 12112 CLAYTON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2516
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Country | US
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Telephone | 314-308-8786
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Fax |
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Provider Business Mailing Address
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Address Line | 12110 CLAYTON RD
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2599
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Country | US
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Telephone | 314-989-8150
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2021012094
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-19-34559
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License Number State | MO
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