Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack L. Croughan Inc

Organization Addiction Medicine (Psychiatry & Neurology) Physician · NPI 1982928065

Jack L. Croughan Inc is an Addiction Medicine (Psychiatry & Neurology) Physician in Saint Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2010.

Licensed in
MO
In the registry since
2010
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1034 S Brentwood Blvd Ste 970
Saint Louis, MO 63117-1223
Phone: (314) 725-4004
Fax: (314) 725-4004
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence R5543 (MO)
Addiction Medicine (Psychiatry & Neurology) Physician Taxonomy 2084A0401X · Licence R5543 (MO)

Record details

NPI number1982928065
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jack Croughan — President · (314) 725-4004
NPI enumeratedMarch 18, 2010
Last updated in NPPESMarch 18, 2010
Mailing address1034 S Brentwood Blvd, Suite 970, Saint Louis, MO 63117-1223

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