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General NPI Number Information
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NPI Number | 1659513851
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Entity Type | Organization
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Legal Business Name | SELF CARE AND COUNSELING LLC
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 2536 S OLD HIGHWAY 94 SUITE 120
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City | SAINT CHARLES
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State | MO
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Zip | 63303-5612
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Country | US
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Telephone | 636-447-4198
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Fax |
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Provider Business Mailing Address
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Address Line | 2536 S OLD HIGHWAY 94 SUITE 120
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City | SAINT CHARLES
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State | MO
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Zip | 63303-5612
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Country | US
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Telephone | 636-447-4198
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | JACQUELINE BARNES
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Credential | LCSW
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Telephone | 636-447-4198
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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 | 2007001152
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License Number State | MO
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