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General NPI Number Information
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NPI Number | 1679168132
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Entity Type | Organization
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Legal Business Name | BRINKMAN & GARDINER LLC
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Dates
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Enumeration Date | 03/06/2021
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Last Update Date | 03/06/2021
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Provider Practice Location Address
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Address Line | 677 CRAIG RD STE 216
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City | CREVE COEUR
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State | MO
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Zip | 63141-7125
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Country | US
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Telephone | 314-276-2387
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Fax |
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Provider Business Mailing Address
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Address Line | 13717 AMIOT DR
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3609
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Country | US
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Telephone | 314-276-2387
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Fax |
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Authorized Official
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Title or Position | OWNER/LEAD COUNSELOR AND CONSULTANT
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Name | MS. JEAN MARIE GARDINER
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Credential | MS, LPC, BCB
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Telephone | 314-276-2387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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