Provider Demographics
NPI:1376134825
Name:A PLACE WITHIN, LLC
Entity Type:Organization
Organization Name:A PLACE WITHIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:PREBYS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, RPT, RSP
Authorized Official - Phone:314-579-4044
Mailing Address - Street 1:4507 LACLEDE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2103
Mailing Address - Country:US
Mailing Address - Phone:314-579-4044
Mailing Address - Fax:314-579-4046
Practice Address - Street 1:4507 LACLEDE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2103
Practice Address - Country:US
Practice Address - Phone:314-579-4044
Practice Address - Fax:314-579-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)