Provider Demographics
NPI:1679110498
Name:ST. LOUIS PLAY THERAPY INSTITUTE
Entity type:Organization
Organization Name:ST. LOUIS PLAY THERAPY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, RPT
Authorized Official - Phone:314-240-5109
Mailing Address - Street 1:1123 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63101-1103
Mailing Address - Country:US
Mailing Address - Phone:314-240-5109
Mailing Address - Fax:314-492-4009
Practice Address - Street 1:1123 LOCUST ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1103
Practice Address - Country:US
Practice Address - Phone:314-240-5109
Practice Address - Fax:314-492-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-01
Last Update Date:2019-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health