MARY M. DICK, MD LLC (NPI# 1396001723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396001723 |
| Entity Type | Organization |
| Organization Name | MARY M. DICK, MD LLC |
| Other Organization Name | MARY M. DICK, INC |
| Practice Address |
2100 E Broadway Suite 325 Columbia MO 65201-6082 |
| Practice Telephone | 5734495800 |
| Practice Fax Number | 5736934190 |
| Mailing Telephone | 5734495800 |
| Mailing Fax Number | 5736934190 |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2012-04-10 |
| Authorized Official Name | MARY MARGARET DICK (OWNER) |
| Authorized Official Telephone | 5734495800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
R8178 | MO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | COVENTRY HEALTH CARE PLAN | 309074 | 01 |
| MO | ANTHEM BLUE CROSS BLUE SHIELD | 12382 | 01 |
| Other Name | Type Code |
|---|---|
| Mary M. Dick, Inc | Former Legal Business Name - Organization |
| Street Address |
2100 E BROADWAY SUITE 325 |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65201-6082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336144435 | Robert Eichenberger | Counselor | 2100 E Broadway, Ste 305, Columbia, MO 65201-6082 | 2005-06-15 |
| 1346618717 | Kenneth Lee Ostercamp | Counselor | 2100 E Broadway, Suite 205, Columbia, MO 65201-6082 | 2015-09-02 |
| 1528356524 | Joshua C. Hulen & Associates | Counselor | 2100 E Broadway, Suite 200a, Columbia, MO 65201-6082 | 2011-07-12 |
| 1154556116 | Linda Ann Townsend | Counselor | 2100 E Broadway, Suite 317, Columbia, MO 65201-6082 | 2009-05-20 |
| 1790975779 | Joshua C. Hulen | Counselor | 2100 E Broadway, Suite 200a, Columbia, MO 65201-6082 | 2007-07-26 |
| 1497966857 | Wilburn Patrick Kane | Social Worker | 2100 E Broadway, Suite 213 Stephens Lake Bldg, Columbia, MO 65201-6082 | 2007-05-25 |
| 1124235825 | Pamela Arlene Mauch | Psychologist | 2100 E Broadway, Suite 213 Stephens Lake Bldg, Columbia, MO 65201-6082 | 2007-05-16 |
| 1285739383 | Mary Margaret Dick | Psychiatry & Neurology | 2100 E Broadway, Suite 325, Columbia, MO 65201-6082 | 2006-09-13 |
| 1760465439 | Wayne Huddleston | Chiropractor | 2100 E Broadway, Suite 308, Columbia, MO 65201-6082 | 2005-11-26 |
| 1114922242 | Betty Acree | Counselor | 2100 E Broadway, Ste 313, Columbia, MO 65201-6082 | 2005-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134688534 | Thomas Havey | Specialist/Technologist | 600 E Stadium Boulevard, Columbia, MO 65201 | 2019-03-15 |
| 1881176121 | Darrea L Green | Nurse Practitioner | 3700 Interstate 70 Dr Se, Columbia, MO 65201 | 2018-09-04 |
| 1073092383 | Andrea L. Lingenfelter | Registered Nurse | 1605 East Broadway, Ste. 100, Columbia, MO 65201 | 2018-08-08 |
| 1144724238 | Angela Marie Richmond | Internal Medicine | 1 Hospital Dr Rm Ma423, Columbia, MO 65201 | 2018-03-22 |
| 1770092892 | Palmer's Home Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 701 Hillsdale Road, Columbia, MO 65201 | 2017-09-20 |
| 1205358710 | Mitchell E Swee | Specialist/Technologist | 600 East Stadium Blvd, Columbia, MO 65201 | 2017-07-17 |
| 1659815470 | Colleen Jockin | Specialist | 100 Matc, Columbia, MO 65201 | 2016-12-13 |
| 1720535305 | Hannah Garrad | Dietitian, Registered | Columbia 3, 25 Conley Road, Columbia, MO 65201 | 2016-09-01 |
| 1043662570 | Restoration Chiropractic LLC | Chiropractor | 1413 Grindstone Plaza Drive, Columbia, MO 65201 | 2016-07-08 |
| 1306298930 | Taylor John Sirois | Chiropractor | 1413 Grindstone Plaza Dr., Columbia, MO 65201 | 2016-07-07 |
| Find all providers in zip 65201 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215405782 | Lumos Counseling & Wellness Center | Clinic/Center | 5537 Twin Knolls Rd Ste 439, Columbia, MD 21045-3270 | 2018-11-02 |
| 1508235110 | Health Access 360, LLC | Clinic/Center | 4711 Forest Dr Ste 3-276, Columbia, SC 29206-3125 | 2015-09-24 |
| 1861875908 | Whetstone Valley Stables LLC | Clinic/Center | 3368 Murphy Ln, Columbia, TN 38401-5741 | 2015-07-07 |
| 1013292465 | University of Missouri Student Health Center | Clinic/Center | 1101 Hospital Drive Dc 800 00, Columbia, MO 65212-0001 | 2011-10-18 |
| 1982984365 | Reality House, Inc. | Clinic/Center | 1900 E Prathersville Rd, Columbia, MO 65202-9260 | 2011-08-17 |
| 1336387778 | Pollock Psychiatry LLC | Clinic/Center | 116 Belle Grove Cir, Columbia, SC 29229-8906 | 2009-01-22 |
| 1538760657 | Breakthrough Behavioral Health Services LLC | Clinic/Center | 5457 Twin Knolls Rd Ste 300, Columbia, MD 21045-3296 | 2020-11-04 |
| 1831797539 | New England Holistic Well-being Center LLC | Clinic/Center | 4 Doubleday Rd, Columbia, CT 06237-1405 | 2020-10-14 |
| 1932737624 | Maya Rake, Lisw-cp LLC | Clinic/Center | 2221 Bull St, Columbia, SC 29201-1901 | 2020-03-30 |
| 1942854021 | Bridgette Ratnam, LLC | Clinic/Center | 10015 Old Columbia Rd Ste B215, Columbia, MD 21046-1865 | 2019-07-28 |
| Find all providers in COLUMBIA | ||||
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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.