MEDICARE: THREE CIRCLES OF HEALING LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1427881978
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THREE CIRCLES OF HEALING LLC

Provider Business Mailing Address
First Line	:	9378 OLIVE BLVD STE 104A
Second Line	:
City	:	OLIVETTE
State	:	MO
Zip	:	63132-3222
Country	:	US
Telephone Number	:	314-669-6396
Fax Number	:

Provider Business Practice Location Address
First Line	:	9378 OLIVE BLVD STE 104A
Second Line	:
City	:	OLIVETTE
State	:	MO
Zip	:	63132-3222
Country	:	US
Telephone Number	:	314-669-6396
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ALYSSA CASTANO-MANN
Credential	:	LCSW
Telephone Number	:	314-669-6396

Provider Enumeration Date	:	08/21/2024
Last Update Date	:	08/21/2024

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Directions to “THREE CIRCLES OF HEALING LLC ” Practice Location

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