MEDICARE: DR. HILLEL GOLDSTEIN PSYD, 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	101YP2500X	Professional Counselor	2007029527	MO

General Provider Information

NPI Number	:	1689063638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HILLEL GOLDSTEIN PSYD, LPC

Provider Business Mailing Address
First Line	:	7850 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-2710
Country	:	US
Telephone Number	:	314-645-7230
Fax Number	:	844-527-4893

Provider Business Practice Location Address
First Line	:	7850 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-2710
Country	:	US
Telephone Number	:	314-645-7230
Fax Number	:	844-527-4893

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

Provider Enumeration Date	:	01/14/2015
Last Update Date	:	10/28/2019

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