Provider Demographics
NPI:1760968093
Name:R8:28
Entity Type:Organization
Organization Name:R8:28
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LAUREN
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-368-5996
Mailing Address - Street 1:1147 APPLESEED LANE
Mailing Address - Street 2:APT A
Mailing Address - City:OLIVETTE
Mailing Address - State:MO
Mailing Address - Zip Code:63132
Mailing Address - Country:US
Mailing Address - Phone:314-368-5996
Mailing Address - Fax:
Practice Address - Street 1:4068 MAFFITT
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63113
Practice Address - Country:US
Practice Address - Phone:314-368-5996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015006074101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty