Provider Demographics
NPI:1568646917
Name:NESTER, JOAN L (LPC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:L
Last Name:NESTER
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 1:11469 OLIVE BLVD STE 217
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7108
Mailing Address - Country:US
Mailing Address - Phone:314-479-9028
Mailing Address - Fax:866-387-2869
Practice Address - Street 1:1375 CARMAN RD
Practice Address - Street 2:BEREAN HOUSE
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63021-5600
Practice Address - Country:US
Practice Address - Phone:314-479-9028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004014255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional