MEDICARE: MARSHA KAREN MOORE ANDREOFF

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	000066	MO

General Provider Information

NPI Number	:	1861512733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARSHA KAREN MOORE ANDREOFF

Provider Business Mailing Address
First Line	:	9117 CLAYTON RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63124-1801
Country	:	US
Telephone Number	:	314-432-1845
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 S NEW BALLAS RD
Second Line	:	SUITE 129 WEST
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-8705
Country	:	US
Telephone Number	:	314-432-4556
Fax Number	:	314-997-8874

Authorized Official
Title or Position	:	L.P.C.
Name	:	MARSHA ANDREOFF
Credential	:	M.A.
Telephone Number	:	314-432-4556

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/22/2020

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