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General NPI Number Information
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NPI Number | 1750772224
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Entity Type | Organization
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Legal Business Name | RED THREAD COUNSELING
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 10260 MANCHESTER RD
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City | SAINT LOUIS
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State | MO
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Zip | 63122-1519
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Country | US
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Telephone | 314-719-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 7626 ALICIA AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63143-1204
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Country | US
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Telephone | 314-853-3105
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | JENNA MUELLER
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Credential | MA, LPC, NCC
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Telephone | 314-719-6500
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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 | 2009027398
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License Number State | MO
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