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NPI Code Detail

MEDICARE: ERIN ELIZABETH LAKEBRINK PLPC

MEDICARE: ERIN ELIZABETH LAKEBRINK PLPC
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
1101YM0800XMental Health Counselor2014000749MO

General Provider Information

NPI Number : 1336564376
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN ELIZABETH LAKEBRINK PLPC
Provider Business Mailing Address
First Line : 1401 N TRUMAN BLVD
Second Line :
City : FESTUS
State : MO
Zip : 63028-1177
Country : US
Telephone Number : 636-933-4104
Fax Number : 636-933-4049
Provider Business Practice Location Address
First Line : 1401 N TRUMAN BLVD
Second Line :
City : FESTUS
State : MO
Zip : 63028-1177
Country : US
Telephone Number : 636-933-4104
Fax Number : 636-933-4049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2014
Last Update Date : 02/27/2014

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Directions to “ ERIN ELIZABETH LAKEBRINK PLPC” Practice Location

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