Organization
THE COMMUNITY COUNSELING & HOUSING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN SHELTON ED.S, ED.D, RADC-P (CEO)
(314) 580-3029
Entity
Organization
Contact information
Practice address
4764 BEACON AVE, SAINT LOUIS, MO 63120-2208
(314) 580-3029
Mailing address
4166 LINDELL BLVD APT 1B, SAINT LOUIS, MO 63108-2923
(314) 580-3029
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
251B00000X
Case Management Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
273R00000X
Psychiatric Hospital Unit
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
02/08/2018
Last updated
04/17/2020
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