Provider Demographics
NPI:1538459086
Name:RAPP, JOHN GREGORY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:GREGORY
Last Name:RAPP
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 WYNSTAY AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY PARK
Mailing Address - State:MO
Mailing Address - Zip Code:63088-1442
Mailing Address - Country:US
Mailing Address - Phone:314-456-9127
Mailing Address - Fax:
Practice Address - Street 1:13975 MANCHESTER RD STE 2
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-4500
Practice Address - Country:US
Practice Address - Phone:573-424-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-17
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130142251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical