MEDICARE: EASTER SEALS MIDWEST

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	2205030351	MO
2	224Z00000X	Occupational Therapy Assistant	2010005293	MO
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4	251C00000X	Developmentally Disabled Services Day Training Agency
5	225X00000X	Occupational Therapist	2001015378	MO
6	231H00000X	Audiologist
7	235Z00000X	Speech-Language Pathologist	118073	MO
8	104100000X	Social Worker	1999140934	MO
9	104100000X	Social Worker	001967	MO
10	103K00000X	Behavior Analyst

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	:	1871625582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTER SEALS MIDWEST

Provider Business Mailing Address
First Line	:	11933 WESTLINE INDUSTRIAL DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-3203
Country	:	US
Telephone Number	:	314-394-7100
Fax Number	:	314-394-4007

Provider Business Practice Location Address
First Line	:	11933 WESTLINE INDUSTRIAL DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-3203
Country	:	US
Telephone Number	:	314-394-7100
Fax Number	:	314-394-4007

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	JEFF ARLEDGE
Credential	:
Telephone Number	:	314-394-7020

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	12/05/2025

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Directions to “EASTER SEALS MIDWEST ” Practice Location

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