Stephanie Costley Hedgecock, LPC

Individual provider Active NPI Professional Counselor · Des Peres, MO

NPI 1770895435 · NPPES record last updated Jul 10, 2010

Key facts

NPI
1770895435
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2008028480 (MO)
Practice address
12015 Manchester Rd
Suite 155
Des Peres, MO 63131-4423
Phone
(314) 479-6571
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
Yes

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
2008028480MOMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2008028480 MO Yes

Addresses

Primary practice location

12015 Manchester Rd
Suite 155
Des Peres, MO 63131-4423

Mailing address

12015 Manchester Rd
Suite 155
Des Peres, MO 63131-4423
Phone (314) 479-6571

Other providers in Des Peres, MO

All providers in Des Peres, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.