ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER (NPI# 1942449194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942449194 |
Entity Type | Organization |
Organization Name | ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER |
Practice Address |
5355 Page Avenue St. Louis MO 63112 |
Mailing Address |
2612 Annie Malone Drive St. Louis MO 63113 |
Practice Telephone | 3145310120 |
Practice Fax Number | 3145310125 |
Mailing Telephone | 3145310120 |
Mailing Fax Number | 3145310125 |
Enumeration Date | 2009-02-11 |
Last Update Date | 2020-02-05 |
Authorized Official Name | CHANNEL GENISE THOMAS (DIRECTOR OF CLINICAL AND OUTPATIENT) |
Authorized Official Telephone | 3145651110 |
Authorized Official Credential | M.ED. LPC TF-CBT |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 385H00000X | Respite Care | 001305902 | MO | Respite Care Facility |
N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 002136058 | MO | Residential Treatment Facilities |
N | 251300000X | Local Education Agency (LEA) | SEO200902 | MO | Agencies |
Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 1942449194 | 05 | |
MO | 506278209 | 05 |
Street Address |
5355 PAGE AVENUE |
City | ST. LOUIS |
State | MO |
Zip Code | 63112 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851932990 | Bobbie J. Harrington | Technician | 5626 Julian Avenue, St. Louis, MO 63112 | 2019-09-30 |
1861901480 | Christina Cummings | Counselor | 5387 Pershing Ave., Apt. A, St. Louis, MO 63112 | 2017-09-26 |
1326457177 | Clare Marie Salley | Speech-Language Pathologist | 5673 Waterman Blvd, Unit 31, St Louis, MO 63112 | 2014-08-06 |
1386999324 | Family Love Adult Health Care Center, LLC | Clinic/Center | 286 Debaliviere Avenue, St. Louis, MO 63112 | 2012-07-16 |
1003133893 | William Richard Humphrey II | Chiropractor | 5615 Pershing, Suite 22, St. Louis, MO 63112 | 2010-05-03 |
1558688408 | Courtney Lynne Luster | Counselor | 5647 Delmar Blvd Ste 226, Saint Louis, MO 63112 | 2010-04-30 |
1134446602 | Donald Trevor Cross | Psychologist | #7 Beverly Place, St. Louis, MO 63112 | 2010-04-23 |
1649507328 | Vikram Choudhary | Prosthetist | 6126 Washington Blvd, # 201, St. Louis, MO 63112 | 2009-11-17 |
1992930325 | Kelly Brook Hogan | Social Worker | 5355 Delmar, Saint Louis, MO 63112 | 2009-05-29 |
1568626349 | Dannie E Williams | Family Medicine | 5621 Delmar Blvd Ste 108, Saint Louis, MO 63112 | 2008-07-11 |
Find all providers in zip 63112 |
Taxonomy Code | 261QM0855X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Adolescent and Children Mental Health |
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497354781 | Community Treatment Inc | Clinic/Center | 106 N Mill St, Festus, MO 63028-1816 | 2020-10-19 |
1962025072 | Empowering Transformations, LLC | Clinic/Center | 5842 Walsh St, Saint Louis, MO 63109-3120 | 2020-05-22 |
1548895790 | Ozark Trails Youth Services | Clinic/Center | 40840 Cr Rd 181-280, Willow Springs, MO 65793-6579 | 2020-03-09 |
1366076721 | Midwest Psychological Services, LLC | Clinic/Center | 220 W Argonne Dr Ste B, Kirkwood, MO 63122-4237 | 2020-02-25 |
1851860209 | Preferred Family Healthcare, Inc | Clinic/Center | 3300 S National Ave Ste 500, Springfield, MO 65807-7343 | 2018-11-15 |
1548759251 | Stacey Juengst Counseling Services | Clinic/Center | 1000 Edgewater Point Drive, Suite 401, Lake Saint Louis, MO 63367-2954 | 2018-05-08 |
1982129722 | Solid Ground Counseling Services, LLC | Clinic/Center | 2515 W Allen Dr, Springfield, MO 65810-1300 | 2017-08-12 |
1740714823 | Storge LLC | Clinic/Center | 7114 Vernon Ave, University City, MO 63130-2301 | 2017-04-17 |
1437527314 | Emotional Health Therapy | Clinic/Center | 7730 Carondelet Ave, Suite 307, Saint Louis, MO 63105-3314 | 2015-09-09 |
1114055076 | Burrell, Inc. | Clinic/Center | 3301 Berrywood Dr Ste 101, Columbia, MO 65201-6517 | 2007-03-01 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER.
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.