Basic Information
Provider Information
NPI: 1033876537
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12655 OLIVE BLVD FL 4
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631416291
CountryCode: US
TelephoneNumber: 3148511000
FaxNumber:  
Practice Location
Address1: 9580 WATSON RD STE A
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631261539
CountryCode: US
TelephoneNumber: 6366952690
FaxNumber: 6366252046
Other Information
ProviderEnumerationDate: 11/19/2021
LastUpdateDate: 11/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X2021043446MOY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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