Heather Lynn Bauer, MAC, LPC

Individual provider Active NPI Professional Counselor · Saint Louis, MO

NPI 1083928352 · NPPES record last updated Jan 18, 2022

Key facts

NPI
1083928352
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2010024364 (MO)
Practice address
711 Old Ballas Rd Ste 203
Saint Louis, MO 63141-7069
Phone
(314) 806-1023
NPI assigned
Jul 28, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2010024364MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Christian Counseling Professional Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2010024364 MO Yes

Addresses

Primary practice location

711 Old Ballas Rd Ste 203
Saint Louis, MO 63141-7069

Mailing address

639 Highview Circle Dr
Ballwin, MO 63021-7804
Phone (314) 605-1460

Other identifiers

IdentifierTypeStateIssuer
2010024364OtherMOPROVISIONAL LICENSE NUMBER

Electronic endpoints

TypeEndpointUseAffiliation
Other URL hbauer@sanalake.com Direct
Other URL hbauer@sanalake.com Direct

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.