Individual
DR. BRIAN SHEBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D, NCSP, LPC, NCC
Contact information
Practice address
745 CRAIG RD STE 111, CREVE COEUR, MO 63141-7122
(314) 302-3594
Mailing address
4163 AVERY LN, BRIDGETON, MO 63044-3402
(314) 302-3594
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2017009643
MO
101YM0800X
Mental Health Counselor
Primary
2017009643
MO
101YP2500X
Professional Counselor
2017009643
MO
103TS0200X
School Psychologist
258425
MO
103TS0200X
School Psychologist
38296 NCSP
MO
Other
Enumeration date
06/26/2015
Last updated
05/10/2019
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