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JERRY WAGGONER LPC L.L.C.
NPI 1548546583
Community/Behavioral Health in Lake Saint Louis, MO

Active since October 21, 2011
1000 LAKE SAINT LOUIS BLVD STE 260, LAKE SAINT LOUIS, MO 63367(314) 994-9344 Get Directions Write a Review

NPPES record last updated: October 21, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerry Waggoner Lpc L.l.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JERRY WAGGONER LPC L.L.C. (NPI 1548546583) is a healthcare organization registered as a community/behavioral health in Lake Saint Louis, Missouri and active in the NPI registry since October 2011. The organization lists Jerry Waggoner, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1548546583
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameJERRY WAGGONER LPC L.L.C.
Location Address1000 LAKE SAINT LOUIS BLVD STE 260Lake Saint Louis, MO 63367-2924
Mailing Address36 S Lake DrHillsboro, MO 63050-4424 · (636) 633-1980
Phone(314) 994-9344
Organization SubpartNo
Authorized OfficialJerry WaggonerSole Member · (636) 633-1980
Enumeration DateOctober 21, 2011
✔ NPI 1548546583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in MO · 001573
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
1000 LAKE SAINT LOUIS BLVD STE 260, Lake Saint Louis, MO 63367
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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.

ZACHARY J SANDER LPC
Counselor (Professional)
1000 LAKE SAINT LOUIS BLVD STE 260
LAKE ST LOUIS, MO 63367
St. Charles County (314) 994-9344
KARISSA CURTIS MA, LPC
Counselor (Professional)
1000 LAKE SAINT LOUIS BLVD STE 260
LAKE SAINT LOUIS, MO 63367
St. Charles County (636) 734-7015

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerry Waggoner Lpc L.L.C.'s NPI number?

The NPI number for Jerry Waggoner Lpc L.L.C. is 1548546583. It was assigned to this organization in the NPPES registry on October 21, 2011.

Where is Jerry Waggoner Lpc L.L.C. located?

Jerry Waggoner Lpc L.L.C. is located at 1000 Lake Saint Louis Blvd Ste 260, Lake Saint Louis, MO 63367. The listed phone number is (314) 994-9344.

What is Jerry Waggoner Lpc L.L.C.'s specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Jerry Waggoner Lpc L.L.C. was last updated on October 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.