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NPI Code Detail

MEDICARE: JOYCE HATHAWAY LPC

MEDICARE: JOYCE HATHAWAY 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
1101YM0800XMental Health Counselor2015028807MO
2101YP2500XProfessional Counselor2015028807MO

General Provider Information

NPI Number : 1831647809
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYCE HATHAWAY LPC
Provider Business Mailing Address
First Line : 1510 GREGG AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63139-3004
Country : US
Telephone Number : 630-788-5839
Fax Number :
Provider Business Practice Location Address
First Line : 11042 MANCHESTER RD
Second Line :
City : KIRKWOOD
State : MO
Zip : 63122-1244
Country : US
Telephone Number : 314-669-6452
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2016
Last Update Date : 11/03/2024

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Directions to “ JOYCE HATHAWAY LPC” Practice Location

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