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NPI Code Detail

MEDICARE: MYPATHTOSELF INC.

MEDICARE: MYPATHTOSELF INC.
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 Counselor

General Provider Information

NPI Number : 1700596772
Entity Type Code : Organization
Provider Name (Legal Business Name) : MYPATHTOSELF INC.
Provider Business Mailing Address
First Line : 365 REMINGTON WAY DR
Second Line :
City : BALLWIN
State : MO
Zip : 63021-6379
Country : US
Telephone Number : 314-650-9537
Fax Number :
Provider Business Practice Location Address
First Line : 12810 TESSON FERRY RD STE 103
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63128-2913
Country : US
Telephone Number : 314-650-9537
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SARONI KUNDU
Credential :
Telephone Number : 314-650-9537
Provider Enumeration Date : 12/01/2022
Last Update Date : 05/16/2025

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