Provider Demographics
NPI:1609550938
Name:CONSCIOUS REFLECTIONS THERAPY, LLC
Entity Type:Organization
Organization Name:CONSCIOUS REFLECTIONS THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:CHANEL
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, VA
Authorized Official - Phone:314-699-4379
Mailing Address - Street 1:3430 MCKELVEY RD STE L
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2556
Mailing Address - Country:US
Mailing Address - Phone:314-699-4379
Mailing Address - Fax:
Practice Address - Street 1:3057 WILLOW CREEK ESTATES DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-1667
Practice Address - Country:US
Practice Address - Phone:314-699-4379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty