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NPI Code Detail

MEDICARE: SARA KHALEDPOUR LPC

MEDICARE: SARA KHALEDPOUR LPC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2101YP2500XProfessional Counselor2019000814MO

General Provider Information

NPI Number : 1225386055
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA KHALEDPOUR LPC
Provider Business Mailing Address
First Line : 400 N 5TH ST STE 201
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-1808
Country : US
Telephone Number : 636-238-2615
Fax Number :
Provider Business Practice Location Address
First Line : 400 N 5TH ST STE 201
Second Line :
City : SAINT CHARLES
State : MO
Zip : 63301-1808
Country : US
Telephone Number : 636-238-2615
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2012
Last Update Date : 03/19/2024

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Directions to “ SARA KHALEDPOUR LPC” Practice Location

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