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General NPI Number Information
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NPI Number | 1962749424
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Entity Type | Organization
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Legal Business Name | ABOUT FACE COUNSELING, LLC
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 10213 NORTHWOOD DRIVE
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City | BLACKWELL
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State | MO
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Zip | 63626-9521
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Country | US
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Telephone | 314-722-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 10213 NORTHWOOD DRIVE
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City | BLACKWELL
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State | MO
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Zip | 63626-9521
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Country | US
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Telephone | 573-202-9790
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ELMA KATHERINE MCBROOM
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Credential | LPC
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Telephone | 573-202-9790
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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 | 2010033339
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License Number State | MO
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