Provider Demographics
NPI:1114061462
Name:CAINE, JEAN STANTON (LCSW, LMFT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:STANTON
Last Name:CAINE
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 CLAYTON RD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1328
Mailing Address - Country:US
Mailing Address - Phone:314-781-9181
Mailing Address - Fax:314-781-4883
Practice Address - Street 1:7750 CLAYTON RD STE 204
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1342
Practice Address - Country:US
Practice Address - Phone:314-781-9181
Practice Address - Fax:314-781-4883
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO300053106H00000X
MOSW0021821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist