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General NPI Number Information
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NPI Number | 1609787936
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Entity Type | Organization
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Legal Business Name | IRIS COUNSELING CENTER
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 4122 KEATON CROSSING BLVD STE 106B
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City | O FALLON
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State | MO
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Zip | 63368-8218
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Country | US
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Telephone | 865-604-3630
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Fax |
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Provider Business Mailing Address
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Address Line | 7701 BOARDWALK TOWER CIR
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City | O FALLON
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State | MO
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Zip | 63368-4169
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Country | US
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Telephone | 865-604-3630
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATELYN WALKER
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Credential | LPC
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Telephone | 865-604-3630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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