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General NPI Number Information
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NPI Number | 1609550938
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Entity Type | Organization
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Legal Business Name | CONSCIOUS REFLECTIONS THERAPY, LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 3057 WILLOW CREEK ESTATES DR
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City | FLORISSANT
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State | MO
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Zip | 63031-1667
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Country | US
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Telephone | 314-699-4379
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Fax |
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Provider Business Mailing Address
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Address Line | 3430 MCKELVEY RD STE L
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City | BRIDGETON
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State | MO
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Zip | 63044-2556
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Country | US
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Telephone | 314-699-4379
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Fax |
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Authorized Official
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Title or Position | OWNER, CEO
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Name | DR. JESSICA CHANEL HUGHES
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Credential | PHD, LPC, VA
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Telephone | 314-699-4379
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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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