Provider Demographics
NPI:1477726230
Name:SWEET, GAIL B (LPC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:B
Last Name:SWEET
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 1:3309 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63139-1101
Mailing Address - Country:US
Mailing Address - Phone:314-534-9350
Mailing Address - Fax:314-533-6047
Practice Address - Street 1:4926 REBER PL
Practice Address - Street 2:3309 S. KINGSHIGHWAY BLVD.
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-1028
Practice Address - Country:US
Practice Address - Phone:314-534-9350
Practice Address - Fax:314-533-6047
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-11
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001004032101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2001004032OtherLPC