Organization
NEW LEAF FAMILY SERVICES, LLC
Active
Organization
NEW LEAF FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARYBETH GRAS LCSW (LICENSED CLINICAL SOCIAL WORKER)
(314) 629-9862
Entity
Organization
Contact information
Practice address
4625 LINDELL BLVD, SUITE 315, SAINT LOUIS, MO 63108-3729
(314) 629-9862
Mailing address
4200 SHENANDOAH AVE, SAINT LOUIS, MO 63110-3513
(314) 629-9862
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001022248
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176889
BLUE CROSS BLUE SHIELD
MO
Enumeration date
01/05/2006
Last updated
08/22/2020
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