Doctor Name: | MRS. ELAINE THAYER |
NPI Number: | 1942536503 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 000549 |
Business Practice Address: | 1121 Olivette Executive Pkwy Suite 210 Olivette, MO - 631323254 |
Business Phone Number: | 3147128354 |
Business Fax Number: | 3148728033 |
Mailing Address: | 1121 Olivette Executive Pkwy, Suite 210 OLIVETTE |
State: | MO |
Postal Code: | 631323254 |
Phone Number: | 3147128354 |
Fax Number: | 3148728033 |
NPI Enumeration Date: | 11/02/2009 |
NPI Last Update Date: | 11/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 000549 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |