Individual
DR. PATRICK CHARLES STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.MIN
Contact information
Practice address
10702 MANCHESTER RD, KIRKWOOD, MO 63122-1321
(314) 966-1022
(314) 968-7126
Mailing address
11 VILLAWOOD LN, WEBSTER GROVES, MO 63119-4916
(314) 963-1962
(314) 968-7126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2775
MO
101YP2500X
Professional Counselor
000122
MO
106H00000X
Marriage & Family Therapist
300107
MO
Other
Enumeration date
05/15/2007
Last updated
09/11/2025
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