Provider Demographics
NPI:1023394319
Name:CAREPOINT CHRISTIAN COUNSELING, LLC
Entity Type:Organization
Organization Name:CAREPOINT CHRISTIAN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-258-6184
Mailing Address - Street 1:12166 OLD BIG BEND RD STE 204
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6836
Mailing Address - Country:US
Mailing Address - Phone:314-822-8888
Mailing Address - Fax:
Practice Address - Street 1:12166 OLD BIG BEND RD
Practice Address - Street 2:STE 307
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6844
Practice Address - Country:US
Practice Address - Phone:314-258-6184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006038842101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty