Provider Demographics
NPI:1447403365
Name:SHENHAV, SMEDAR (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SMEDAR
Middle Name:
Last Name:SHENHAV
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:SMEDAR
Other - Middle Name:DEKEL
Other - Last Name:SHENHAV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10950 SCHUETZ RD.
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-5704
Mailing Address - Country:US
Mailing Address - Phone:314-993-1000
Mailing Address - Fax:314-812-9305
Practice Address - Street 1:10950 SCHUETZ RD.
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-5704
Practice Address - Country:US
Practice Address - Phone:314-993-1000
Practice Address - Fax:314-812-9305
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060260831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical