Provider Demographics
NPI:1437682887
Name:PASTOR, MARY R (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:R
Last Name:PASTOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROOKINGS DR
Mailing Address - Street 2:MSC-1201-323-100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-4862
Mailing Address - Country:US
Mailing Address - Phone:314-935-6666
Mailing Address - Fax:314-696-1214
Practice Address - Street 1:1 BROOKINGS DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-4862
Practice Address - Country:US
Practice Address - Phone:314-935-6666
Practice Address - Fax:314-696-1214
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014038414101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional