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NPI Code Detail

MEDICARE: LIZA B KEBEL MA, LPC

MEDICARE: LIZA B KEBEL MA, 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 Counselor2016025099MO

General Provider Information

NPI Number : 1457703860
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIZA B KEBEL MA, LPC
Provider Business Mailing Address
First Line : 255 SPENCER RD STE 101
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-2574
Country : US
Telephone Number : 636-939-2550
Fax Number : 314-222-0514
Provider Business Practice Location Address
First Line : 255 SPENCER RD STE 101
Second Line :
City : SAINT PETERS
State : MO
Zip : 63376-2574
Country : US
Telephone Number : 636-939-2550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2016
Last Update Date : 06/28/2023

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