1013313378 NPI number — MRS. ERIN ELIZABETH MCBRIDE LPC

Table of content: MRS. ERIN ELIZABETH MCBRIDE LPC (NPI 1013313378)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013313378 NPI number — MRS. ERIN ELIZABETH MCBRIDE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCBRIDE
Provider First Name:
ERIN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCCUAN
Provider Other First Name:
ERIN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013313378
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6651 CHIPPEWA ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST. LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-645-6840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17300 N. OUTER 40 RD.
Provider Second Line Business Practice Location Address:
STE 212
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-645-6840
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  2005028638 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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