Provider Demographics
NPI:1538359930
Name:SCARBERRY, CHRISTOPHER BLAKE (LPC)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BLAKE
Last Name:SCARBERRY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12465 MUSTONE LN APT 202
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-2851
Mailing Address - Country:US
Mailing Address - Phone:314-469-8721
Mailing Address - Fax:314-583-9681
Practice Address - Street 1:4507B LACLEDE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2103
Practice Address - Country:US
Practice Address - Phone:314-750-5216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007008763101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional