1417040916 NPI number — ANOTHER WAY COUNSELING SERVICES, INC.

Table of content: (NPI 1417040916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417040916 NPI number — ANOTHER WAY COUNSELING SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANOTHER WAY COUNSELING SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417040916
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1345 APOLLO DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARNOLD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63010-3001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-550-6097
Provider Business Mailing Address Fax Number:
636-296-3290

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1331 JEFFCO BLVD.
Provider Second Line Business Practice Location Address:
SUITE #4
Provider Business Practice Location Address City Name:
ARNOLD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63010-2165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-550-6097
Provider Business Practice Location Address Fax Number:
636-296-3290
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRADY
Authorized Official First Name:
JOAN
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
314-550-6097

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW005299 , 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)

  • Identifier: 499685626 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com