Organization
AGAPE COUNSELING SERVICE INC
Active
Organization
AGAPE COUNSELING SERVICE INC
Active
Other names
Agape Counseling Service
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORENZA JOHN COTTON LCSW (PRESIDENT)
(314) 531-1600
Entity
Organization
Contact information
Practice address
4144 LINDELL BLVD, SUITE 402, ST LOUIS, MO 63108
(314) 531-1601
(314) 727-1921
Mailing address
1569 QUENDO AVENUE, ST LOUIS, MO 63130-1419
(314) 727-7277
(314) 727-1921
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2000164578
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
20001164578
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000165478
LCSW MARRIAGE & FAMILY THERAPY
MO
05
—
495945404
—
MO
01
—
856261409
MEDICAID WAIVER
MO
05
—
856261409
—
MO
01
—
CASAC 2513
ADDICTION DIAGNOSIS & TREARMENT
MO
Enumeration date
08/12/2008
Last updated
09/30/2008
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