Provider Demographics
NPI:1568668846
Name:PRICE, DEBORAH ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ANN
Last Name:PRICE
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 1:4144 LINDELL BOULEVARD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108
Mailing Address - Country:US
Mailing Address - Phone:314-440-2029
Mailing Address - Fax:314-645-3981
Practice Address - Street 1:4144 LINDELL BLVD
Practice Address - Street 2:SUITE 402
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2927
Practice Address - Country:US
Practice Address - Phone:314-780-3854
Practice Address - Fax:314-645-3981
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02696101YM0800X
MOCS002696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490953908Medicaid
MO213189OtherANTHEM BLCROSSBL SHIELD