=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386860294
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASHER PSYCHIATRY AND PSYCHOTHERAPY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4130 LINDELL BLVD
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63108-2914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-667-3410
-----------------------------------------------------
Fax | 314-667-3177
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4130 LINDELL BLVD
-----------------------------------------------------
City | SAINT LOUIS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63108-2914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 314-667-3410
-----------------------------------------------------
Fax | 314-667-3177
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF PSYCHIATRY
-----------------------------------------------------
Name | DR. JARON MICHAEL ASHER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 314-667-3410
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 112864
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------