COMMUNITY BEHAVIORAL HEALTH CENTERS OF MISSOURI, LLC (NPI# 1972129179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972129179 |
| Entity Type | Organization |
| Organization Name | COMMUNITY BEHAVIORAL HEALTH CENTERS OF MISSOURI, LLC |
| Practice Address |
1528 Highway H Farmington MO 63640-7042 |
| Practice Telephone | 5739154123 |
| Mailing Telephone | 5739154123 |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | MR. MARK ERNEST WARDLOW (OWNER) |
| Authorized Official Telephone | 5739154123 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
1528 HIGHWAY H |
| City | FARMINGTON |
| State | MO |
| Zip Code | 63640-7042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942544630 | Mark Ernest Wardlow Jr. | Counselor | 1528 Highway H, Farmington, MO 63640-7042 | 2012-11-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1619519089 | Stacey Nicole Gillette | Counselor | 17885 Hart Pinkston Rd, Farmington, MO 63640 | 2019-10-17 |
| 1346890696 | Christopher Ryan Massey | Social Worker | 607 Pine St., Farmington, MO 63640 | 2019-09-18 |
| 1457909376 | Clarice Ogden | Social Worker | 203 South Washington Street, Farmington, MO 63640 | 2019-09-04 |
| 1861979718 | Clint Thebeau | In Home Supportive Care | 1276 W Liberty St, Farmington, MO 63640 | 2018-07-24 |
| 1023500600 | Lynn Machelle Knox | Counselor | 219 W Columbia St, Farmington, MO 63640 | 2018-05-31 |
| 1235620576 | Kim Bazzell | Registered Nurse | 1565 Ste. Genevieve Ave., Farmington, MO 63640 | 2018-05-22 |
| 1164919742 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 774 Market St, Farmington, MO 63640 | 2018-04-18 |
| 1184127813 | Michelle Lynette Corvallis | Chiropractor | 17 South Franklin St., Farmington, MO 63640 | 2018-03-08 |
| 1992206213 | Farmington Vision Care LLC | Optometrist | 110 E Harrison St, Farmington, MO 63640 | 2018-02-22 |
| Find all providers in zip 63640 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710532619 | Solstone, LLC | Clinic/Center | 1353 N 1075 W Ste 204, Farmington, UT 84025-2772 | 2019-08-07 |
| 1063982866 | Charis Counseling Pllc | Clinic/Center | 128 Southwinds Rd Ste 5&6, Farmington, AR 72730-8678 | 2018-12-05 |
| 1114434412 | Mackay Counseling | Clinic/Center | 582 Rigby Rd, Farmington, UT 84025-4404 | 2018-01-08 |
| 1124153366 | Lds Family Services | Clinic/Center | 925 Cannery Ct Ste A, Farmington, NM 87401-4058 | 2007-02-21 |
| 1821635129 | Mindful Transformations LLC | Clinic/Center | 304 Main St, Farmington, CT 06032-2985 | 2019-12-05 |
| 1427610187 | Guiding Solutions Therapy, LLC | Clinic/Center | 128 Southwinds Rd Ste 5, Farmington, AR 72730-8678 | 2019-07-02 |
| 1164940599 | Jean Manz Coaching, LLC | Clinic/Center | 3510 Messina Dr, Farmington, NM 87402-4782 | 2017-09-06 |
| 1588103881 | Dr. Faith Prelli, LLC | Clinic/Center | 304 Main St, Suite 204, Farmington, CT 06032-2985 | 2017-02-20 |
| 1881043487 | South Davis Psychological Services | Clinic/Center | 240 N East Promontory Ste 200, Farmington, UT 84025-2950 | 2016-06-06 |
| 1588028641 | Therapy and Wellness for Women LLC | Clinic/Center | 769 Farmington Ave, Box 11, Farmington, CT 06032-2364 | 2016-04-05 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 63640 |
Please comment or provide details below to improve the information on COMMUNITY BEHAVIORAL HEALTH CENTERS OF MISSOURI, LLC.
| 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.