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General NPI Number Information
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NPI Number | 1821668864
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Entity Type | Organization
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Legal Business Name | STEPHANIE DEVEREUX LPC LLC
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 2536 S OLD HIGHWAY 94 STE 234
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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 | 636-352-2947
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Fax | 636-947-3155
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Provider Business Mailing Address
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Address Line | 53 PENSACOLA CT
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City | O FALLON
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State | MO
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Zip | 63368-6689
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Country | US
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Telephone | 636-219-6678
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Fax | 636-947-3155
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | STEPHANIE DEVEREUX
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Credential | LPC
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Telephone | 636-219-6678
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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 |
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License Number State |
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