Provider Demographics
NPI:1710188628
Name:ECHOLS, TENECIA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:TENECIA
Middle Name:ANN
Last Name:ECHOLS
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 1:1201 CARNEGIE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6301
Mailing Address - Country:US
Mailing Address - Phone:636-248-0561
Mailing Address - Fax:636-922-5815
Practice Address - Street 1:1201 CARNEGIE DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6301
Practice Address - Country:US
Practice Address - Phone:636-248-0561
Practice Address - Fax:636-922-5815
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW20030005651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical