Provider Demographics
NPI:1659635456
Name:DIGGS, GLORIA (LCSW)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:DIGGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 S GRAND BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-1046
Mailing Address - Country:US
Mailing Address - Phone:636-323-9829
Mailing Address - Fax:
Practice Address - Street 1:3115 S GRAND BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-1046
Practice Address - Country:US
Practice Address - Phone:636-323-9829
Practice Address - Fax:314-552-7051
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110299721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1041C0700XOtherLCSW