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Organization

MELVIN A. TANN, ACSW, LCSW, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MELVIN AVON TANN ACSW, LCSW (OWNER)
(314) 644-4600
Entity
Organization

Contact information

Practice address
7750 CLAYTON RD STE 300, SAINT LOUIS, MO 63117-1341
(314) 644-4600
(314) 644-3274
Mailing address
7750 CLAYTON RD STE 300, SAINT LOUIS, MO 63117-1341
(314) 644-4600
(314) 644-3274

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW003913
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111089000
COMMUNITY CAREPLUS
MO
01
117385
ANTHEM BLUE CROSS & BLUE SHIELD
MO
01
120062
VALUEOPTIONS
MO
01
19323745924
MEDICARE ORGANIZATION
MO
01
196019
MHNET
MO
01
270157
PRINCIPAL LIFE INS. CO.
MO
05
496893306
MO
01
5628917
CIGNA
MO
01
5791112
AETNA
MO
01
R22291
MERCY
MO
Enumeration date
04/24/2008
Last updated
04/17/2012
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