Basic Information
| Provider Information | |||||||||
| NPI: | 1659867893 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DEEM | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 227 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FESTUS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630281952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6369312700 | ||||||||
| FaxNumber: | 6369315304 | ||||||||
| Practice Location | |||||||||
| Address1: | 1817 GRAVOIS RD | ||||||||
| Address2: | |||||||||
| City: | HIGH RIDGE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630492668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363760079 | ||||||||
| FaxNumber: | 6366778440 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2018 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 2009035151 | MO | N | Behavioral Health & Social Service Providers | Counselor | 171M00000X | 2009035151 | MO | N | Other Service Providers | Case Manager/Care Coordinator | 101YP2500X | 2009035151 | MO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.