MEDICARE: ANASTASIA LINDSEY WEXLER LCSW

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker	2021040032	MO

General Provider Information

NPI Number	:	1376028530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASTASIA LINDSEY WEXLER LCSW

Provider Business Mailing Address
First Line	:	16 AMESBURY CT
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63376-4516
Country	:	US
Telephone Number	:	309-235-2763
Fax Number	:

Provider Business Practice Location Address
First Line	:	511 ASHLAND AVE
Second Line	:
City	:	WARRENTON
State	:	MO
Zip	:	63383-1065
Country	:	US
Telephone Number	:	636-456-0543
Fax Number	:

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

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	07/23/2024

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