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NPI Code Detail

MEDICARE: ALYSSA MICHELLE BUETTNER LCSW

MEDICARE:   ALYSSA MICHELLE BUETTNER  LCSW
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
11041C0700XClinical Social Worker2021013456MO

General Provider Information

NPI Number : 1881443315
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MICHELLE BUETTNER LCSW
Provider Business Mailing Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-678-3068
Fax Number : 314-268-4019
Provider Business Practice Location Address
First Line : 1465 S GRAND BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63104-1003
Country : US
Telephone Number : 314-678-3068
Fax Number : 314-268-4019
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2024
Last Update Date : 12/03/2025

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Directions to “ ALYSSA MICHELLE BUETTNER LCSW” Practice Location

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