Allen, Jessica Pegeen

Allen, Jessica Pegeen is an individual health care provider with primary practice located at 620 N Grand Blvd , Saint Louis MO 63103-1009. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Allen, Jessica Pegeen can be contacted via phone (314) 934-9456.

Contact Information

Primary practice address
620 N Grand Blvd Saint Louis MO 63103-1009
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 2003026254 Missouri
Behavioral Health & Social Service Providers / Clinical 1041C0700X 2003026254 Missouri

Profile Details

NPI number 1730204892
LBN Legal business name Allen, Jessica Pegeen
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated Nov 12th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730204892 NPPES
Missouri MEDICAID 499150308
Missouri Other 2003026254

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