MEDICARE: ALICIA SUTTON CPS

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
1	175T00000X	Peer Specialist	11674	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306198411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA SUTTON CPS

Provider Business Mailing Address
First Line	:	3309 S KINGSHIGHWAY BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-1101
Country	:	US
Telephone Number	:	314-206-3700
Fax Number	:

Provider Business Practice Location Address
First Line	:	8300 EAGER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63144-1405
Country	:	US
Telephone Number	:	314-518-1188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2012
Last Update Date	:	02/05/2025

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Directions to “ ALICIA SUTTON CPS” Practice Location

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