Provider Demographics
NPI:1467042572
Name:TAWNA LEDESMA COUNSELING
Entity Type:Organization
Organization Name:TAWNA LEDESMA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDESMA
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:314-629-4117
Mailing Address - Street 1:7110 OAKLAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1871
Mailing Address - Country:US
Mailing Address - Phone:314-629-4117
Mailing Address - Fax:
Practice Address - Street 1:7110 OAKLAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1871
Practice Address - Country:US
Practice Address - Phone:314-629-4117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty