Provider Demographics
NPI:1053071233
Name:C3 COMMUNITIES, LLC
Entity Type:Organization
Organization Name:C3 COMMUNITIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-744-9002
Mailing Address - Street 1:240 S 74TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-2936
Mailing Address - Country:US
Mailing Address - Phone:618-746-8890
Mailing Address - Fax:
Practice Address - Street 1:4390 LINDELL BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2568
Practice Address - Country:US
Practice Address - Phone:314-956-0547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health