=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760333793
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEADFAST COUNSELING SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2026
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5667 S 60TH RD
-----------------------------------------------------
City | WALNUT GROVE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65770-8395
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-418-9613
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 68
-----------------------------------------------------
City | WALNUT GROVE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65770-0068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 573-418-9613
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MEMBER/THERAPIST
-----------------------------------------------------
Name | MRS. SYDNEY KATHERINE VANDEGRIFT
-----------------------------------------------------
Credential | MSW, LCSW
-----------------------------------------------------
Telephone | 573-418-9613
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------