Provider Demographics
NPI:1710191234
Name:CRESTWOOD CONSULTANTS, INC.
Entity Type:Organization
Organization Name:CRESTWOOD CONSULTANTS, INC.
Other - Org Name:YVONNE I. DEHART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:ICYLEEN
Authorized Official - Last Name:DEHART
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:314-965-5451
Mailing Address - Street 1:12151 LOWILL LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-2900
Mailing Address - Country:US
Mailing Address - Phone:314-965-5451
Mailing Address - Fax:314-842-7904
Practice Address - Street 1:10000 WATSON RD
Practice Address - Street 2:SUITE 2L18
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1854
Practice Address - Country:US
Practice Address - Phone:314-965-5451
Practice Address - Fax:314-965-5451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS000370101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty