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NPI Code Detail

MEDICARE: DR. TERRY VARNEY FREERKS PH.D.

MEDICARE:  DR. TERRY VARNEY FREERKS  PH.D.
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 Counselor001497MO
2106H00000XMarriage & Family Therapist300096MO
3101YM0800XMental Health CounselorIL

General Provider Information

NPI Number : 1568443067
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY VARNEY FREERKS PH.D.
Provider Business Mailing Address
First Line : 1321 W LOCKWOOD AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63122-4817
Country : US
Telephone Number : 314-918-7248
Fax Number : 314-918-7016
Provider Business Practice Location Address
First Line : 7349 DALE AVE
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-2241
Country : US
Telephone Number : 314-918-7248
Fax Number : 314-918-7016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 09/11/2025

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