Provider Demographics
NPI:1609224971
Name:INIZIO COUNSELING CENTER
Entity Type:Organization
Organization Name:INIZIO COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / LICENSED PROFESSIONAL COUNS
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-775-9289
Mailing Address - Street 1:10805 SUNSET OFFICE DR STE L108
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1025
Mailing Address - Country:US
Mailing Address - Phone:314-775-9289
Mailing Address - Fax:
Practice Address - Street 1:10805 SUNSET OFFICE DR STE L108
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1025
Practice Address - Country:US
Practice Address - Phone:314-775-9289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001001599101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1588860753Medicaid