Doctor Name: | MR. MICHAEL RICHARD NIEHAUS |
NPI Number: | 1003806662 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 2000150484 |
Business Practice Address: | 232 Vance Rd Suite 206 Valley Park, MO - 630881575 |
Business Phone Number: | 6362253700 |
Business Fax Number: | 6362253709 |
Mailing Address: | 232 Vance Rd, Suite 206 SAINT LOUIS |
State: | MO |
Postal Code: | 630881575 |
Phone Number: | 6362253700 |
Fax Number: | 6362253709 |
NPI Enumeration Date: | 10/25/2005 |
NPI Last Update Date: | 12/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2000150484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |