Provider Demographics
NPI:1992456883
Name:REACHING BEYOND RESILIENCE
Entity type:Organization
Organization Name:REACHING BEYOND RESILIENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALEHWA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-884-1307
Mailing Address - Street 1:3109 MAYBELLE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-4242
Mailing Address - Country:US
Mailing Address - Phone:314-709-0543
Mailing Address - Fax:
Practice Address - Street 1:7777 BONHOMME AVE STE 1800
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-1931
Practice Address - Country:US
Practice Address - Phone:314-884-1307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty