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Organization

FERN LANE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW SWANGO LCSW (OWNER)
(217) 929-8651
Entity
Organization

Contact information

Practice address
10424 TIFFANY VILLAGE CT, SAINT LOUIS, MO 63123-8001
(217) 929-8651
(314) 828-1232
Mailing address
10424 TIFFANY VILLAGE CT, SAINT LOUIS, MO 63123-8001

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
06/09/2022
Last updated
09/14/2022
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