Organization
PSYCHOTHERAPY LLC
Active
Organization
PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA BLACKWELL (CLINICAL SOCIAL WORKER)
(573) 315-5549
Entity
Organization
Contact information
Practice address
508 N TRUMAN BLVD STE F, CRYSTAL CITY, MO 63019-1344
(636) 931-8784
(636) 465-0026
Mailing address
508 N TRUMAN BLVD STE F, CRYSTAL CITY, MO 63019-1344
(636) 931-8784
(636) 465-0026
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
07/03/2026
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