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CHILD AND ADOLESCENT LIFE THERAPY
NPI 1639736515
Counselor - Professional in Saint Louis, MO

Active since May 25, 2019
4390 LINDELL BLVD STE 200, SAINT LOUIS, MO 63108 Get Directions Write a Review

NPPES record last updated: May 25, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Child And Adolescent Life Therapy NPPES

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

CHILD AND ADOLESCENT LIFE THERAPY (NPI 1639736515) is a healthcare organization registered as a professional in Saint Louis, Missouri and active in the NPI registry since May 2019. The organization lists Courtney L Luster, Mental Health Therapist, as its authorized official.

NPPES Registry Identity

NPI1639736515
Entity TypeOrganization
Primary Taxonomy101YP2500X
Legal Business NameCHILD AND ADOLESCENT LIFE THERAPY
Location Address4390 LINDELL BLVD STE 200Saint Louis, MO 63108-2735
Mailing Address4390 Lindell Blvd Ste 200Saint Louis, MO 63108-2735 · (314) 744-9002
Organization SubpartNo
Authorized OfficialCourtney L LusterMental Health Therapist · (314) 440-8468
Enumeration DateMay 25, 2019
✔ NPI 1639736515 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
4390 LINDELL BLVD STE 200, Saint Louis, MO 63108
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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.

MRS. AISHA GILLIAM LPC
Counselor (Professional)
4390 LINDELL BLVD STE 200
SAINT LOUIS, MO 63108
St. Louis City (314) 956-0547
AYLIN HERNANDEZ M.A., LPC
Counselor (Mental Health)
4390 LINDELL BLVD STE 200
SAINT LOUIS, MO 63108
St. Louis City (314) 956-0547

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 Child And Adolescent Life Therapy's NPI number?

The NPI number for Child And Adolescent Life Therapy is 1639736515. It was assigned to this organization in the NPPES registry on May 25, 2019.

Where is Child And Adolescent Life Therapy located?

Child And Adolescent Life Therapy is located at 4390 Lindell Blvd Ste 200, Saint Louis, MO 63108.

What is Child And Adolescent Life Therapy's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Child And Adolescent Life Therapy was last updated on May 25, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.