Provider Demographics
NPI:1588119507
Name:THERAPY SERVICES
Entity type:Organization
Organization Name:THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHUNDRA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-873-9723
Mailing Address - Street 1:1868 MCKELVEY HILL DR
Mailing Address - Street 2:APT D
Mailing Address - City:MARYLAND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63043-3926
Mailing Address - Country:US
Mailing Address - Phone:314-873-9723
Mailing Address - Fax:
Practice Address - Street 1:1868 MCKELVEY HILL DR
Practice Address - Street 2:APT D
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-3926
Practice Address - Country:US
Practice Address - Phone:314-873-9723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016016569251G00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251G00000XAgenciesHospice Care, Community Based