Fournelle, Roger J

Fournelle, Roger J is an individual health care provider with primary practice located at 3720 Hampton Ave Suite 207, Saint Louis MO 63109-1438. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Fournelle, Roger J can be contacted via phone (314) 559-4209.

Contact Information

Primary practice address
3720 Hampton Ave Suite 207 Saint Louis MO 63109-1438
Phone: (314) 559-4209
Fax: (314) 752-9445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 61290
Behavioral Health & Social Service Providers / Professional 101YP2500X 2000152363 Missouri
Behavioral Health & Social Service Providers / Psychologist 103T00000X 01194

Profile Details

NPI number 1538138375
LBN Legal business name Fournelle, Roger J
Credentials MED LPC NCC NCP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Jul 8th, 2007 - about 17 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 1538138375 NPPES
Missouri Other 179068 BLUE CROSS BLUE SHIELD
Missouri Other 7811255 BLUE CROSS BLUE SHIELD

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