Provider Demographics
NPI:1992833974
Name:ST. LOUIS ACADEMY
Entity Type:Organization
Organization Name:ST. LOUIS ACADEMY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCONAGHY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-481-5100
Mailing Address - Street 1:4601 MORGANFORD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63116-1409
Mailing Address - Country:US
Mailing Address - Phone:314-481-5100
Mailing Address - Fax:314-259-1147
Practice Address - Street 1:4601 MORGANFORD RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-1409
Practice Address - Country:US
Practice Address - Phone:314-481-5100
Practice Address - Fax:314-259-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty