Organization
BERTHELOT COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILSON BERTHELOT (OFFICE MANAGER)
(573) 624-9383
Entity
Organization
Contact information
Practice address
212 S WALNUT ST, DEXTER, MO 63841-2144
(573) 624-9383
Mailing address
212 S WALNUT ST, DEXTER, MO 63841-2144
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001694
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
479804914
—
MO
Enumeration date
04/26/2007
Last updated
06/20/2008
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