PSYCH ASSOCIATES LLC (NPI# 1316458441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316458441 |
| Entity Type | Organization |
| Organization Name | PSYCH ASSOCIATES LLC |
| Practice Address |
1358 E Kingsley St Ste E Springfield MO 65804 |
| Mailing Address |
1358 E Kingsley St Ste E Springfield MO 65804-7245 |
| Practice Telephone | 4174140333 |
| Practice Fax Number | 4174140333 |
| Mailing Telephone | 4174140333 |
| Mailing Fax Number | 4174140333 |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2018-09-13 |
| Authorized Official Name | GABRIEL A CLINE (OWNER) |
| Authorized Official Telephone | 4174140333 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
2010006114 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1558555045 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2407 S Campbell Ave, Springfield, MO 658072903 | 4174140333 | 4174140333 |
| Street Address |
1358 E KINGSLEY ST STE E |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619200490 | Stephanie M Wacaser | Social Worker | 1358 E Kingsley St Ste E, Springfield, MO 65804 | 2009-09-11 |
| 1124665799 | Alisha Dawn Ross | Counselor | 1358 E Kingsley St Ste E, Springfield, MO 65804-7245 | 2019-12-03 |
| 1013471143 | Ian Thomas Douglas | Counselor | 1358 E Kingsley St Ste E, Springfield, MO 65804-7245 | 2019-01-23 |
| 1891266375 | Healing Bridge LLC | Community/Behavioral Health | 1358 E Kingsley St Ste E, Springfield, MO 65804-7245 | 2018-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117240 | Sherri Marie Mccray | Psychologist | 4 Florence Hill Ct, Black Jack, MO 63033-7230 | 2020-09-03 |
| 1740844844 | Shantiela Hall | Psychologist | 1238 Oxford Hill Ct Apt 9, Saint Louis, MO 63146-5721 | 2019-04-24 |
| 1073045340 | Iesha Joseph | Psychologist | 7251 Olive Blvd, Saint Louis, MO 63130-2322 | 2017-03-28 |
| 1346647906 | Emona Lashelle Ewharekuko | Psychologist | 2162 Cherry Ave, Saint Louis, MO 63121-5625 | 2014-11-25 |
| 1164680237 | Rumi Kato Price | Psychologist | Cid Bldg Washington University School of Medicine, Dept of Psychiatry, St Louis, MO 63110 | 2008-05-27 |
| 1083813869 | Kathleen M. Baggett | Psychologist | 5125 Tracy Ave, Kansas City, MO 64110-2515 | 2007-07-12 |
| 1790707123 | Paul Lynn Susic | Psychologist | 2451 Executive Dr. Ste. 103, St. Charles, MO 63303 | 2006-07-24 |
| 1912567322 | Christopher Poitevien | Psychologist | 1 Childrens Pl Ste 3n-14, Saint Louis, MO 63110-1002 | 2019-06-18 |
| 1285810432 | New Beginnings Behavioral Health | Psychologist | 729 W Center Cir, Suite 103, Nixa, MO 65714-7001 | 2008-01-18 |
| 1639353915 | Psychological Consultants PC | Psychologist | 6405 N Cosby Ave, Suite 203, Kansas City, MO 64151-2378 | 2007-12-22 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.