Provider Demographics
NPI:1710029426
Name:VERITY, JERRI ANN (MED, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JERRI
Middle Name:ANN
Last Name:VERITY
Suffix:
Gender:F
Credentials:MED, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 CAMINO DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-3812
Mailing Address - Country:US
Mailing Address - Phone:314-544-8189
Mailing Address - Fax:314-544-8189
Practice Address - Street 1:4177 CRESCENT DR
Practice Address - Street 2:SUITE D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-1071
Practice Address - Country:US
Practice Address - Phone:314-680-8190
Practice Address - Fax:314-544-8189
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002032137174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO175969OtherBCBS ID