MR. IAN THOMSON BRECKENRIDGE LPC
NPI 1811614803
Counselor - Mental Health in Wentzville, MO
Active since October 20, 2022
About Mr. Ian Thomson Breckenridge Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. IAN THOMSON BRECKENRIDGE LPC (NPI 1811614803) is an individual mental health provider in Wentzville, Missouri, licensed in Missouri (2017044140) and active in the NPI registry since October 2022. He maintains 2 additional practice locations.
NPPES Registry Identity
NPI1811614803
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. IAN THOMSON BRECKENRIDGECredential: LPC
Location Address1642 WOODS MILL DRWentzville, MO 63385-2629
Mailing Address1642 Woods Mill DrWentzville, MO 63385-2629 · (314) 442-5320
Phone(314) 442-5320
Sole ProprietorYes
Enumeration DateOctober 20, 2022
NPPES CertifiedOctober 20, 2022
✔ NPI 1811614803 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MO · 2017044140
1642 WOODS MILL DR, Wentzville, MO 63385
Secondary Practice Locations 2
Location 15336 Main StCottleville, MO 63304-8002 · Phone (314) 442-5320
Location 21611 Highway WForistell, MO 63348-1016 · Phone (314) 442-5320
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1811614803, enumerated as an "individual" on October 20, 2022.
The provider is located at 1642 WOODS MILL DR WENTZVILLE, MO 63385 and the phone number is (314) 442-5320.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
