MEDICARE: MR. ALLEN E SCHENK 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
1	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1659427599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALLEN E SCHENK LPC

Provider Business Mailing Address
First Line	:	2316 ADA WORTLEY AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-5071
Country	:	US
Telephone Number	:	314-869-2408
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 THEOBALD ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63147-1922
Country	:	US
Telephone Number	:	314-388-2777
Fax Number	:	314-388-4903

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/08/2007

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