Individual
JESSICA PEGEEN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 N GRAND BLVD, SAINT LOUIS, MO 63103-1009
(314) 934-9456
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2003026254
MO
1041C0700X
Clinical Social Worker
Primary
2003026254
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003026254
LCSW
MO
05
—
499150308
—
MO
Enumeration date
03/20/2007
Last updated
11/12/2020
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