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NPI Code Detail

MEDICARE: LARONDA TREADWAY LPC

MEDICARE:   LARONDA  TREADWAY  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
1101YP2500XProfessional Counselor2022045386MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12022045386OTHERMOPROFESSIONAL LICENSE

General Provider Information

NPI Number : 1245937127
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARONDA TREADWAY LPC
Provider Business Mailing Address
First Line : 1600 2ND ST
Second Line :
City : MADISON
State : IL
Zip : 62060-1441
Country : US
Telephone Number : 314-599-4657
Fax Number :
Provider Business Practice Location Address
First Line : 12 FEE FEE RD
Second Line :
City : MARYLAND HEIGHTS
State : MO
Zip : 63043-2729
Country : US
Telephone Number : 314-368-2409
Fax Number : 949-577-4014
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2023
Last Update Date : 06/04/2026

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Directions to “ LARONDA TREADWAY LPC” Practice Location

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