Provider Demographics
NPI:1710912225
Name:MOJESKE, SUSAN M (PHD, LPC, CCMHC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:M
Last Name:MOJESKE
Suffix:
Gender:F
Credentials:PHD, LPC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4808 TURLEY MILL RD
Mailing Address - Street 2:APT. 5
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-1117
Mailing Address - Country:US
Mailing Address - Phone:314-920-6937
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:A-398
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-920-6937
Practice Address - Fax:314-251-7722
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001601101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health