Organization
PROVIDENT INC.
Active
Other names
Provident Behavioral Health, Provident Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY S SCHLEMMER (RELATIONS COORDINATOR)
(314) 802-2647
Entity
Organization
Contact information
Practice address
2650 OLIVE ST, SAINT LOUIS, MO 63103-1424
(314) 371-6500
(314) 371-1155
Mailing address
2650 OLIVE ST, SAINT LOUIS, MO 63103-1424
(314) 371-6500
(314) 371-1155
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA5670
MEDICARE ID
MO
Enumeration date
01/29/2007
Last updated
10/05/2022
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