Provider Demographics
NPI:1013342187
Name:BLESSING, THERESA MARIE (LPC, NBCC, LCPC)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MARIE
Last Name:BLESSING
Suffix:
Gender:F
Credentials:LPC, NBCC, LCPC
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:PACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8350 STATE ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:DITTMER
Mailing Address - State:MO
Mailing Address - Zip Code:63023-1909
Mailing Address - Country:US
Mailing Address - Phone:636-707-2097
Mailing Address - Fax:
Practice Address - Street 1:711 OLD BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7051
Practice Address - Country:US
Practice Address - Phone:314-806-1025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013033414101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPENDINGMedicaid