Provider Demographics
NPI:1740469758
Name:THERAPY AND BEYOND, LLC
Entity type:Organization
Organization Name:THERAPY AND BEYOND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LPC
Authorized Official - Phone:636-239-5588
Mailing Address - Street 1:864 ELIZABETH ANNE LN
Mailing Address - Street 2:
Mailing Address - City:LABADIE
Mailing Address - State:MO
Mailing Address - Zip Code:63055-1067
Mailing Address - Country:US
Mailing Address - Phone:636-239-5588
Mailing Address - Fax:636-239-2275
Practice Address - Street 1:864 ELIZABETH ANNE LN
Practice Address - Street 2:
Practice Address - City:LABADIE
Practice Address - State:MO
Practice Address - Zip Code:63055-1067
Practice Address - Country:US
Practice Address - Phone:636-239-5588
Practice Address - Fax:636-239-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001828101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO066379OtherRN
MO001828OtherMASTER'S ADDICTION COUNSE
MO001828OtherLPC