Provider Demographics
NPI:1104008341
Name:BIALECKI, LAUREN (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BIALECKI
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:QUALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:9450 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-1452
Mailing Address - Country:US
Mailing Address - Phone:314-504-1541
Mailing Address - Fax:314-963-0393
Practice Address - Street 1:9450 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-1452
Practice Address - Country:US
Practice Address - Phone:314-504-1541
Practice Address - Fax:314-963-0393
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006004870101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional