Provider Demographics
NPI:1457823262
Name:BRYANT, MASHEGA S (LPC)
Entity type:Individual
Prefix:
First Name:MASHEGA
Middle Name:S
Last Name:BRYANT
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:MASHEG
Other - Middle Name:S
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:899 PRIGGE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-3548
Mailing Address - Country:US
Mailing Address - Phone:314-598-1244
Mailing Address - Fax:
Practice Address - Street 1:5647 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63112-2615
Practice Address - Country:US
Practice Address - Phone:314-531-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018029620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health