MS. SHIRLEY ANN WELLS M.ED., LPC NPI 1003001504

Counselor (Professional) in Saint Louis, MO

About SHIRLEY WELLS

Shirley Wells is a provider in Saint Louis, MO. The NPI number assigned to this provider is 1003001504. The practitioner's primary taxonomy code is Counselor (101YP2500X). The provider is registered as an individual and their NPI record was last updated 9 years ago.

NPI

1003001504

Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameMS. SHIRLEY ANN WELLS M.ED., LPC
Provider Location Address3309 S. KINGSHIGHWAY BLVD FAMILY RESOURCE CENTER SAINT LOUIS, MO 63139 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address7511 WARWICK DR SAINT LOUIS, MO 63121 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderFemale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date09-08-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date09-21-2009 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Primary Taxonomy

Taxonomy Code101YP2500X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationCounselor
TypeBehavioral Health & Social Service Providers
SpecializationProfessional
License No.2002013515
License StateMO

Business Address

MS. SHIRLEY ANN WELLS M.ED., LPC
3309 S. KINGSHIGHWAY BLVD
FAMILY RESOURCE CENTER
SAINT LOUIS, MO
ZIP 63139
Phone: (314) 534-1204

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Mailing Address

MS. SHIRLEY ANN WELLS M.ED., LPC
7511 WARWICK DR
SAINT LOUIS, MO
ZIP 63121
Phone: (314) 382-7997
Fax: (314) 382-7997

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1780749317MR. MICHAEL JOHN MEHAN M.S.W.,L.C.S.W.
Individual
Social Worker (Clinical)3309 S. KINGSHIGHWAY BLVD
ST. LOUIS, MO 63139
(314) 534-9350
Previous NPI
1003001496
Next NPI
1003001512