Organization
LIBERATE LEARNING INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON-PIERRE MITCHOM PLPC (FOUNDER/CEO)
(314) 690-9433
Entity
Organization
Contact information
Practice address
801 N 11TH ST, SAINT LOUIS, MO 63101-1015
(314) 690-9433
Mailing address
3833 MCREE AVE, SAINT LOUIS, MO 63110-2619
(314) 690-9433
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
MO
101YP2500X
Professional Counselor
—
MO
1041C0700X
Clinical Social Worker
—
MO
251S00000X
Community/Behavioral Health Agency
Primary
—
MO
Other
Enumeration date
06/21/2016
Last updated
06/24/2016
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