Basic Information
| Provider Information | |||||||||
| NPI: | 1407192131 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAVEEN | ||||||||
| FirstName: | LAKSHMI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 411130 | ||||||||
| Address2: | |||||||||
| City: | CREVE COEUR | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631413130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3144426717 | ||||||||
| FaxNumber: | 6363334509 | ||||||||
| Practice Location | |||||||||
| Address1: | 3015 N BALLAS RD | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631312329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1434426717 | ||||||||
| FaxNumber: | 6363334509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2012 | ||||||||
| LastUpdateDate: | 10/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0805X | 2021015108 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry | 390200000X | 2012042471 | MO | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.