DR. PATRICK CHARLES STACK D.MIN
NPI 1407062383
Counselor - Addiction (Substance Use Disorder) in Kirkwood, MO
Active since May 15, 2007
About Dr. Patrick Charles Stack D.min NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. PATRICK CHARLES STACK D.MIN (NPI 1407062383) is an individual addiction (substance use disorder) provider in Kirkwood, Missouri, licensed in Missouri (2775) and active in the NPI registry since May 2007.
NPPES Registry Identity
NPI1407062383
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameDR. PATRICK CHARLES STACKCredential: D.MIN
Location Address10702 MANCHESTER RDKirkwood, MO 63122-1321
Mailing Address11 Villawood LnWebster Groves, MO 63119-4916 · (314) 963-1962 · Fax (314) 968-7126
Phone(314) 966-1022
Fax(314) 968-7126
Sole ProprietorYes
Enumeration DateMay 15, 2007
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1407062383 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 3
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in MO · 2775
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 000122 (MO)
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 300107 (MO)
10702 MANCHESTER RD, Kirkwood, MO 63122
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407062383, enumerated as an "individual" on May 15, 2007.
The provider is located at 10702 MANCHESTER RD KIRKWOOD, MO 63122 and the phone number is (314) 966-1022.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
