Provider Demographics
NPI:1780837013
Name:PHILLIPS, MARGARET KAY (LPC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:KAY
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LAKE SAINT LOUIS BLVD STE 134
Mailing Address - Street 2:
Mailing Address - City:LAKE ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-2923
Mailing Address - Country:US
Mailing Address - Phone:636-231-5590
Mailing Address - Fax:
Practice Address - Street 1:1000 LAKE SAINT LOUIS BLVD STE 134
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-2923
Practice Address - Country:US
Practice Address - Phone:636-231-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009032462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional