Provider Demographics
NPI:1376028530
Name:WEXLER, ANASTASIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:WEXLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANASTASIA
Other - Middle Name:
Other - Last Name:NORVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 AMESBURY CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-4516
Mailing Address - Country:US
Mailing Address - Phone:309-235-2763
Mailing Address - Fax:
Practice Address - Street 1:511 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-1065
Practice Address - Country:US
Practice Address - Phone:636-456-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018014725104100000X
1041C0700X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)