MEDICARE: MR. DAVID G GUCKES L.P.C.

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	101Y00000X	Counselor	0000425	MO
2	101YM0800X	Mental Health Counselor	000425	MO
3	101YS0200X	School Counselor		MO
4	101YP2500X	Professional Counselor	000425	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851388946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID G GUCKES L.P.C.

Provider Business Mailing Address
First Line	:	6 HERMIT HOLLOW DR
Second Line	:
City	:	LABADIE
State	:	MO
Zip	:	63055-1720
Country	:	US
Telephone Number	:	314-239-1094
Fax Number	:	636-527-3564

Provider Business Practice Location Address
First Line	:	300 OZARK TRAIL DR STE 220
Second Line	:
City	:	ELLISVILLE
State	:	MO
Zip	:	63011-2156
Country	:	US
Telephone Number	:	314-239-1094
Fax Number	:	636-527-3564

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	10/31/2024

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