Organization
COUNSELING ST. CHARLES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON ROBERSON LPC (COUNSELOR)
(636) 294-0015
Entity
Organization
Contact information
Practice address
109 CHURCH ST, SUITE 105, O FALLON, MO 63366-2894
(636) 294-0015
Mailing address
109 CHURCH ST, SUITE 105, O FALLON, MO 63366-2894
(636) 294-0015
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002217
DIVISION OF PROFESSIONAL REGISTRATION
MO
Enumeration date
09/20/2012
Last updated
09/20/2012
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