MEDICARE: KAREN MACCAUSLAND 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
1	1041C0700X	Clinical Social Worker	SW001086	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	43.1834746	OTHER	MO	TAX IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1972654218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MACCAUSLAND LCSW

Provider Business Mailing Address
First Line	:	4045 N SAINT PETERS PKWY STE 108
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63304-7398
Country	:	US
Telephone Number	:	636-928-5800
Fax Number	:	636-441-3902

Provider Business Practice Location Address
First Line	:	4045 N SAINT PETERS PKWY STE 108
Second Line	:
City	:	SAINT PETERS
State	:	MO
Zip	:	63304-7398
Country	:	US
Telephone Number	:	636-928-5800
Fax Number	:	636-441-3902

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	12/05/2022

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Directions to “ KAREN MACCAUSLAND LCSW” Practice Location

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