Provider Demographics
NPI:1689272742
Name:RAUSCHER, AMY G (LPC, CRC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:G
Last Name:RAUSCHER
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 S KIRKWOOD RD STE 208
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6100
Mailing Address - Country:US
Mailing Address - Phone:314-691-4422
Mailing Address - Fax:
Practice Address - Street 1:439 S KIRKWOOD RD STE 208
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6100
Practice Address - Country:US
Practice Address - Phone:314-691-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017008212101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional