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General NPI Number Information
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NPI Number | 1376134825
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Entity Type | Organization
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Legal Business Name | A PLACE WITHIN, LLC
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 4507 LACLEDE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2103
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Country | US
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Telephone | 314-579-4044
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Fax | 314-579-4046
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Provider Business Mailing Address
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Address Line | 4507 LACLEDE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2103
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Country | US
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Telephone | 314-579-4044
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Fax | 314-579-4046
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. JORDAN LEA PREBYS
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Credential | MA, LPC, RPT, RSP
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Telephone | 314-579-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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