MEDICARE: MISS ADHANET M ZEREABRUK M.A. 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
1	101YP2500X	Professional Counselor	2011039635	MO

General Provider Information

NPI Number	:	1891063376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ADHANET M ZEREABRUK M.A. LPC

Provider Business Mailing Address
First Line	:	PO BOX 21741
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-0741
Country	:	US
Telephone Number	:	314-546-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	2852 LAFAYETTE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2039
Country	:	US
Telephone Number	:	314-546-0307
Fax Number	:	314-442-4084

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

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	04/26/2018

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