Provider Demographics
NPI:1700176310
Name:GARRETT LCSW & CONSULTING, L.L.C.
Entity Type:Organization
Organization Name:GARRETT LCSW & CONSULTING, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:III
Authorized Official - Credentials:LCSW, LICSW
Authorized Official - Phone:314-866-8116
Mailing Address - Street 1:4625 LINDELL BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-3739
Mailing Address - Country:US
Mailing Address - Phone:314-866-8116
Mailing Address - Fax:314-639-9996
Practice Address - Street 1:4625 LINDELL BLVD FL 2
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3739
Practice Address - Country:US
Practice Address - Phone:314-866-8116
Practice Address - Fax:314-639-9996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-15
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110089121041C0700X
WI8370-1231041C0700X
DCLC500808151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO496591702Medicaid