OrganizationActive
Counseling and Assessment Center, LLC
NPI 1184909574 · Community/Behavioral Health Agency · Ellisville, MO
Provider details
- NPI number
- 1184909574
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Stacey Roth-Larose, Sole Member(314) 971-5797
- License
- 2005028635 (MO)
Specialties & taxonomies
Agencies
Practice location
300 Ozark Trail Dr
Suite 220
Ellisville, MO 63011-2166
Phone: (314) 971-5797
Fax: (888) 224-4141
Approximate (ZIP-level) locationGet directions
Mailing address
636 Parker Dr
Ballwin, MO 63021-4836
Registry dates
- Enumerated
- 2011-10-17
- Last updated
- 2011-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.