Provider Demographics
NPI:1033520598
Name:WEINHAUS, EVONNE (LCSW)
Entity Type:Individual
Prefix:
First Name:EVONNE
Middle Name:
Last Name:WEINHAUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 N NEW BALLAS RD
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6737
Mailing Address - Country:US
Mailing Address - Phone:314-499-9144
Mailing Address - Fax:314-499-9188
Practice Address - Street 1:662 N NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6737
Practice Address - Country:US
Practice Address - Phone:314-499-9144
Practice Address - Fax:314-499-9188
Is Sole Proprietor?:No
Enumeration Date:2014-05-17
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health