NEUROTHERAPY CENTER OF ST LOUIS LLC (NPI# 1174921514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174921514 |
| Entity Type | Organization |
| Organization Name | NEUROTHERAPY CENTER OF ST LOUIS LLC |
| Practice Address |
425 Marshall Ave Webster Grvs MO 63119-1833 |
| Mailing Address |
2834 Hampton Ave Saint Louis MO 63139-2627 |
| Practice Telephone | 6365560873 |
| Mailing Telephone | 6365560873 |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2014-12-30 |
| Authorized Official Name | MISS ASHLEY JOE WIEGAND (NEUROTHERAPIST) |
| Authorized Official Telephone | 3093698832 |
| Authorized Official Credential | M.S., LMFT, BCN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | 2013031915 | MO | Behavioral Health & Social Service Providers |
| Y | 246ZE0500X |
Specialist/Technologist, Other Specialization: EEG |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
425 MARSHALL AVE |
| City | WEBSTER GRVS |
| State | MO |
| Zip Code | 63119-1833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114525631 | Kaylen A Howard | Specialist/Technologist | No, No, MO 63119 | 2020-10-16 |
| 1053887612 | St. Gianna Pediatrics, LLC | Pediatrics | 7387 Watson Road, Shrewsbury, MO 63119 | 2018-10-22 |
| 1982140265 | Forefront Dermatology, S.c. | Dermatology | 8567 Watson Rd, Webster Groves, MO 63119 | 2017-01-11 |
| 1407308018 | Tyler Clark | Student in an Organized Health Care Education/Training Program | 7785 Keswick Pl, Saint Louis, MO 63119 | 2016-10-30 |
| 1396109880 | Ritesh Gandhi | Family Medicine | 7345 Watson Rd Ste 203, Saint Louis, MO 63119 | 2016-04-11 |
| 1568834489 | Antonio Robinson | Counselor | 330 N. Gore, Great Circle, Saint Louis, MO 63119 | 2015-10-30 |
| 1922484039 | Odessa Baker X | Dietary Manager | 525 N. Laclede Station Road, St. Louis, MO 63119 | 2015-07-31 |
| 1194114694 | Laura Maher | Social Worker | 201 W. Lockwood Ave, Suite 201, St. Louis, MO 63119 | 2015-01-21 |
| 1427314046 | Dick (richard) Ralph Brummett | Family Medicine | 711 S Laclede Sta Rd, # 2111, St Louis, MO 63119 | 2012-04-09 |
| 1972872935 | Dolliene A. Raabe | Social Worker | 8050 Watson Road, Suite 201, St. Louis, MO 63119 | 2011-12-21 |
| Find all providers in zip 63119 | ||||
| Taxonomy Code | 246ZE0500X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | EEG |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376923367 | Hometown Neurodiagnostics-missouri, LLC | Specialist/Technologist, Other | 303 N Stadium Blvd Ste 200, Columbia, MO 65203-1429 | 2015-06-04 |
| City | WEBSTER GRVS |
| Zip Code | 63119 |
Please comment or provide details below to improve the information on NEUROTHERAPY CENTER OF ST LOUIS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.