Provider Demographics
NPI:1922628163
Name:BAREITER, AMY ADELSBERGER (LPC, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ADELSBERGER
Last Name:BAREITER
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ADELSBERGER
Other - Last Name:BISHOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12551 RAYMOND DR
Mailing Address - Street 2:
Mailing Address - City:WRIGHT CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63390-5701
Mailing Address - Country:US
Mailing Address - Phone:618-531-9238
Mailing Address - Fax:
Practice Address - Street 1:12551 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:WRIGHT CITY
Practice Address - State:MO
Practice Address - Zip Code:63390-5701
Practice Address - Country:US
Practice Address - Phone:618-531-9238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019040284101Y00000X
IL180.011021101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty