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General NPI Number Information
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NPI Number | 1669367348
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Entity Type | Individual
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Provider Name | BRENDAN BENN TEMPLIN
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Gender | Male
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 12141 LADUE RD
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City | CREVE COEUR
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State | MO
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Zip | 63141-8120
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Country | US
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Telephone | 314-898-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 2650 OLIVE ST
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City | SAINT LOUIS
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State | MO
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Zip | 63103-1489
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Country | US
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Telephone | 314-802-2615
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Fax | 314-842-2552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178013219
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2020011784
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License Number State | MO
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