Provider Demographics
NPI:1982052825
Name:ROVINSKY, MICHAEL A (PLPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:ROVINSKY
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 GANNON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3710
Mailing Address - Country:US
Mailing Address - Phone:314-498-6279
Mailing Address - Fax:
Practice Address - Street 1:8001 GANNON AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-3710
Practice Address - Country:US
Practice Address - Phone:314-498-6279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health