Provider Demographics
NPI:1235979691
Name:RAUH, ALICIA NICOLE (LPC)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:NICOLE
Last Name:RAUH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 CRIPPLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-5041
Mailing Address - Country:US
Mailing Address - Phone:573-631-7283
Mailing Address - Fax:
Practice Address - Street 1:2477 CRIPPLE CREEK DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-5041
Practice Address - Country:US
Practice Address - Phone:573-631-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013009866103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling