| Organization Name: | THE CHILDREN'S COUNSELING CENTER |
| NPI Number: | 1902125925 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER WINONA SCHULTE CLARK (PROFESSIONAL COUNSELOR, OWNER) |
| Mailing Address: | 1129 Oakley Ln Lake Saint Louis |
| State: | MO US |
| Postal Code: | 633671957 |
| Phone Number: | 3148528952 |
| Fax Number: | 6368985322 |
| NPI Enumeration Date: | 06/01/2010 |
| NPI Last Update Date: | 06/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2006036523 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |