Organization
COMMUNITY REACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY HUTCHINSON LCSW (OWNER)
(314) 449-7776
Entity
Organization
Contact information
Practice address
3751 PENNRIDGE DR STE 119, BRIDGETON, MO 63044-1244
(314) 443-7776
Mailing address
3751 PENNRIDGE DR STE 119, BRIDGETON, MO 63044-1244
(314) 443-7776
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/30/2020
Last updated
07/16/2024
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