Provider Demographics
NPI:1730208984
Name:PSYCHOLOGICAL TESTING & COUNSELING ASSOC INC
Entity type:Organization
Organization Name:PSYCHOLOGICAL TESTING & COUNSELING ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-832-1077
Mailing Address - Street 1:141 N MERAMEC AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-832-1077
Mailing Address - Fax:314-832-3037
Practice Address - Street 1:7657 TERRI LYNN DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-1674
Practice Address - Country:US
Practice Address - Phone:314-832-1077
Practice Address - Fax:314-832-3037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00331103T00000X
MO001759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty