Provider Demographics
NPI:1710341581
Name:DOUGLAS M FESLER MA LPC
Entity Type:Organization
Organization Name:DOUGLAS M FESLER MA LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:FESLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA LPC
Authorized Official - Phone:314-686-0768
Mailing Address - Street 1:5537 KERTH RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3643
Mailing Address - Country:US
Mailing Address - Phone:314-686-0768
Mailing Address - Fax:
Practice Address - Street 1:14226 LADUE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3344
Practice Address - Country:US
Practice Address - Phone:314-686-0768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014001280251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health