Individual provider · Type 1 NPI
Patrick Charles Stack, D.MIN
Addiction (Substance Use Disorder) Counselor · Kirkwood, MO
NPI number
1407062383
Active
Practice location
10702 Manchester Rd
Kirkwood, MO 63122-1321
Fax (314) 968-7126
Mailing address
11 Villawood Ln
Webster Groves, MO 63119-4916
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 2775 (MO) |
| Professional Counselor | 101YP2500X | 000122 (MO) |
| Marriage & Family Therapist | 106H00000X | 300107 (MO) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
About NPI 1407062383
Patrick Charles Stack, D.MIN's National Provider Identifier is 1407062383, issued on May 15, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Kirkwood, MO. The record was last updated on Sep 11, 2025.