1740230606 NPI number — MS. MARY CAROL STRAUSS-BARRETT LPC, LCSW

Table of content: MS. MARY CAROL STRAUSS-BARRETT LPC, LCSW (NPI 1740230606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740230606 NPI number — MS. MARY CAROL STRAUSS-BARRETT LPC, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRAUSS-BARRETT
Provider First Name:
MARY
Provider Middle Name:
CAROL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740230606
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 PROSPECT AVE
Provider Second Line Business Mailing Address:
SUITE 203K
Provider Business Mailing Address City Name:
KIRKWOOD
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-717-9605
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 PROSPECT AVE
Provider Second Line Business Practice Location Address:
SUITE 203K
Provider Business Practice Location Address City Name:
KIRKWOOD
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
314-843-0080
Provider Business Practice Location Address Fax Number:
314-843-5655
Provider Enumeration Date:
05/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  001134 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 01611 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 176218 . This is a "BC/BS OF MO" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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