Provider Demographics
NPI: | 1386410413 |
---|---|
Name: | KRM THERAPEUTIC ASSOCIATES LLC |
Entity type: | Organization |
Organization Name: | KRM THERAPEUTIC ASSOCIATES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | THERAPEUTIC |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | KAREN |
Authorized Official - Middle Name: | R |
Authorized Official - Last Name: | MOIST |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 314-399-9576 |
Mailing Address - Street 1: | 8147 DELMAR BLVD STE 220 |
Mailing Address - Street 2: | |
Mailing Address - City: | UNIVERSITY CITY |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 63130-3735 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 314-399-9576 |
Mailing Address - Fax: | 314-261-0386 |
Practice Address - Street 1: | 8147 DELMAR BLVD STE 220 |
Practice Address - Street 2: | |
Practice Address - City: | UNIVERSITY CITY |
Practice Address - State: | MO |
Practice Address - Zip Code: | 63130-3735 |
Practice Address - Country: | US |
Practice Address - Phone: | 314-399-9576 |
Practice Address - Fax: | 314-261-0386 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-11-29 |
Last Update Date: | 2023-11-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional | Group - Single Specialty |