Individual provider · Type 1 NPI

Vivian Renee Mack, LPC

Professional Counselor · St. Louis, MO

NPI number 1548307663 Active

Practice location

330 N Gore Ave
St. Louis, MO 63119-1600

Call (314) 968-2060 Map

Specialties and licenses

Taxonomy	Code	License
Professional Counselor	101YP2500X	P0509060 (AR)
Professional Counselor Primary	101YP2500X	2006009257 (MO)

Professional Counselor: Definition to come...

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About NPI 1548307663

Vivian Renee Mack, LPC's National Provider Identifier is 1548307663, issued on Jan 30, 2007. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in St. Louis, MO. The record was last updated on Sep 9, 2016.