Provider Demographics
NPI:1689850653
Name:KREMS, MARCY MORELAND (M ED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:MORELAND
Last Name:KREMS
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:MS
Other - First Name:MARCY
Other - Middle Name:ANNE
Other - Last Name:MORELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:7834 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3711
Mailing Address - Country:US
Mailing Address - Phone:314-610-6068
Mailing Address - Fax:
Practice Address - Street 1:12755 OLIVE BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6242
Practice Address - Country:US
Practice Address - Phone:314-610-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008035989101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor