Individual
STACEY ANNE JUENGST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1000 EDGEWATER PT STE 401, LAKE ST LOUIS, MO 63367-2954
(636) 442-2612
(636) 265-2905
Mailing address
1369 SUNBURST DR, O FALLON, MO 63366-3434
(636) 362-4803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2016001342
MO
101YM0800X
Mental Health Counselor
Primary
2016001342
MO
101YP2500X
Professional Counselor
2016001342
MO
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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