Provider Demographics
NPI:1407267537
Name:CASH, THERESE VERKERKE (PHD LCP)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:VERKERKE
Last Name:CASH
Suffix:
Gender:F
Credentials:PHD LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 MURDOCH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2747
Mailing Address - Country:US
Mailing Address - Phone:434-953-5370
Mailing Address - Fax:
Practice Address - Street 1:6201 MURDOCH AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-2747
Practice Address - Country:US
Practice Address - Phone:434-953-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018019557103TC0700X
VA0810005553103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist