Individual
CHARLES MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LCPC
Contact information
Practice address
5000 MANCHESTER AVE, SAINT LOUIS, MO 63110-2012
(618) 877-4420
Mailing address
5000 MANCHESTER AVE, SAINT LOUIS, MO 63110-2012
(618) 877-4420
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
32660
IL
101YP2500X
Professional Counselor
Primary
180.011349
IL
101YP2500X
Professional Counselor
2018007090
MO
Other
Enumeration date
07/07/2016
Last updated
07/27/2024
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