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General NPI Number Information
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NPI Number | 1568700276
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Entity Type | Organization
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Legal Business Name | ST. LOUIS ADDICTION COUNSELING LLC
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 7954 BIG BEND BLVD SUITE E
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City | SAINT LOUIS
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State | MO
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Zip | 63119-2717
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Country | US
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Telephone | 314-677-7808
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Fax |
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Provider Business Mailing Address
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Address Line | 7954 BIG BEND BLVD SUITE E
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City | SAINT LOUIS
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State | MO
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Zip | 63119-2717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. ANTHONY DAVID ZEHNLE
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Credential |
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Telephone | 314-435-6963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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