Provider Demographics
NPI:1154007490
Name:SHAMELESS THERAPY LLC
Entity type:Organization
Organization Name:SHAMELESS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:314-442-1422
Mailing Address - Street 1:1276 ST. CYR
Mailing Address - Street 2:STE 106, PMB 1059
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1276 ST. CYR
Practice Address - Street 2:STE 106, PMB 1059
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63137
Practice Address - Country:US
Practice Address - Phone:314-442-1422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)