Provider Demographics
NPI:1235484841
Name:WELCH, REUBEN ROBINSON II (PHD)
Entity Type:Individual
Prefix:MR
First Name:REUBEN
Middle Name:ROBINSON
Last Name:WELCH
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:MR
Other - First Name:R.
Other - Middle Name:ROBINSON
Other - Last Name:WELCH
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8134
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-286-1700
Mailing Address - Fax:314-970-9094
Practice Address - Street 1:600 S TAYLOR AVE
Practice Address - Street 2:DEPT PSYCHIATRY, STE 122
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1035
Practice Address - Country:US
Practice Address - Phone:314-286-1700
Practice Address - Fax:314-970-9094
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003030086103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist