Provider Demographics
NPI:1194597674
Name:TRUDELL COUNSELING
Entity type:Organization
Organization Name:TRUDELL COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-232-8328
Mailing Address - Street 1:12764 STATE ROAD TT
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-4345
Mailing Address - Country:US
Mailing Address - Phone:636-232-8328
Mailing Address - Fax:888-388-2740
Practice Address - Street 1:508 N TRUMAN BLVD STE J
Practice Address - Street 2:
Practice Address - City:CRYSTAL CITY
Practice Address - State:MO
Practice Address - Zip Code:63019-1344
Practice Address - Country:US
Practice Address - Phone:636-232-8328
Practice Address - Fax:888-388-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-26
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty