Teresa L Deshields PHD LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

TERESA L DESHIELDS PHD LLC

Practice address

225 S Meramec Ave Ste 432T
Clayton, MO 63105-3597

Phone

(314) 403-5415

NPI assigned

Feb 6, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Teresa L Deshields, PHD

Title

Owner

Phone

(314) 403-5415

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1013472703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 TUSCANY PARK",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053019",
            "telephone_number": "314-517-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE STE 432T",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053597",
            "telephone_number": "314-403-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESA L DESHIELDS PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "DESHIELDS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-403-5415",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.