Organization
COUNSELING AND ASSESSMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACEY ANN ROTH-LAROSE LPC (SOLE MEMBER)
(314) 971-5797
Entity
Organization
Contact information
Practice address
300 OZARK TRAIL DR, SUITE 220, ELLISVILLE, MO 63011-2166
(314) 971-5797
(888) 224-4141
Mailing address
636 PARKER DR, BALLWIN, MO 63021-4836
(314) 971-5797
(888) 224-4141
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2005028635
MO
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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