Provider Demographics
NPI:1871323493
Name:ROWTON, RADONDA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:RADONDA
Middle Name:LYNN
Last Name:ROWTON
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 1:10579 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-2130
Mailing Address - Country:US
Mailing Address - Phone:314-243-8866
Mailing Address - Fax:
Practice Address - Street 1:15455 CONWAY RD STE 117
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-2022
Practice Address - Country:US
Practice Address - Phone:636-675-7566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017043372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional