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General NPI Number Information
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NPI Number | 1508945981
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Entity Type | Organization
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Legal Business Name | CENTERS FOR PROFESSIONAL AND PASTORAL SERVICE
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Dates
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Enumeration Date | 11/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 141 N MERAMEC AVE #205
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City | SAINT LOUIS
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State | MO
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Zip | 63105-3750
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Country | US
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Telephone | 314-776-1319
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Fax | 314-776-1319
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Provider Business Mailing Address
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Address Line | 4949 COLUMBIA AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-1013
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Country | US
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Telephone | 314-776-1319
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Fax | 314-776-1319
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANTOINETTE MARIE TEMPORITI
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Credential | PH.D.
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Telephone | 314-776-1319
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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 | 001338
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License Number State | MO
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