Provider Demographics
NPI:1881083418
Name:MARY SAGGAU MSW LCSW LLC
Entity type:Organization
Organization Name:MARY SAGGAU MSW LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:SAGGAU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:314-974-7040
Mailing Address - Street 1:623 LOUGHMOR PASS
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-0506
Mailing Address - Country:US
Mailing Address - Phone:314-974-7040
Mailing Address - Fax:
Practice Address - Street 1:623 LOUGHMOR PASS
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-0506
Practice Address - Country:US
Practice Address - Phone:314-974-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060069111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty