Shirley Joyce Vandiver, MED LPC

Individual provider Active NPI Professional Counselor · Ofallon, MO

NPI 1629186754 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1629186754
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
001418 (MO)
Practice address
300 Fort Zumwalt Square
Suite 121
Ofallon, MO 63366-3078
Phone
(636) 240-3931
Fax
(636) 639-9312
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
001418MOMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 001418 MO Yes

Addresses

Primary practice location

300 Fort Zumwalt Square
Suite 121
Ofallon, MO 63366-3078

Mailing address

300 Fort Zumwalt Square
Suite 121
Ofallon, MO 63366-3078
Phone (636) 240-3931

Other names

  • Shirley Joyce Curtis Former name

Other providers in Ofallon, MO

All providers in Ofallon, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.