Provider Demographics
NPI:1437286119
Name:ALLEN, EDWARD FRANCIS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:FRANCIS
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 MCCAUSLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3064
Mailing Address - Country:US
Mailing Address - Phone:314-780-7410
Mailing Address - Fax:
Practice Address - Street 1:6978 CHIPPEWA ST
Practice Address - Street 2:SUITE #2
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-3098
Practice Address - Country:US
Practice Address - Phone:314-780-7410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20000167401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health