MEDICARE: MINDS IN PROGRESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1043109887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDS IN PROGRESS LLC

Provider Business Mailing Address
First Line	:	276 ALEXANDRIA DR
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-1014
Country	:	US
Telephone Number	:	314-960-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	3930 S OLD HIGHWAY 94 STE 102
Second Line	:
City	:	SAINT CHARLES
State	:	MO
Zip	:	63304-2836
Country	:	US
Telephone Number	:	314-960-4545
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LICENSED PSYCHOLOGIST
Name	:	MCKINZIE DUESENBERG-MARSHALL
Credential	:	PHD
Telephone Number	:	314-960-4545

Provider Enumeration Date	:	06/28/2025
Last Update Date	:	02/12/2026

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