Provider Demographics
NPI:1093860686
Name:LOITERSTEIN, ASHLEY M (LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:LOITERSTEIN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1430 OLIVE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-2303
Mailing Address - Country:US
Mailing Address - Phone:314-206-3700
Mailing Address - Fax:314-206-3708
Practice Address - Street 1:605 OLD BALLAS RD
Practice Address - Street 2:SUITE 123
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7000
Practice Address - Country:US
Practice Address - Phone:314-989-0302
Practice Address - Fax:314-989-0712
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003003974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health