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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