Individual
GARY CORTLAND CHADWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10 S EUCLID AVE STE C, SAINT LOUIS, MO 63108-3809
(617) 379-0496
Mailing address
5761 S CLAY AVE, SPRINGFIELD, MO 65810-2911
(816) 284-0108
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2010027858
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760701296
—
MO
Enumeration date
05/24/2010
Last updated
07/28/2023
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