MEDICARE: NATALIE N CORIELL LPC, ATR-BC

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	2010016638	MO

General Provider Information

NPI Number	:	1952817702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE N CORIELL LPC, ATR-BC

Provider Business Mailing Address
First Line	:	2502 FLORENT AVE
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143-1912
Country	:	US
Telephone Number	:	217-316-6851
Fax Number	:

Provider Business Practice Location Address
First Line	:	2814 SUTTON BLVD
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143-3010
Country	:	US
Telephone Number	:	314-485-9164
Fax Number	:

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

Provider Enumeration Date	:	12/15/2017
Last Update Date	:	12/15/2017

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