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

Meditelecare of Missouri LLC

Organization Clinical Psychologist · NPI 1013416585

Meditelecare of Missouri LLC is a Clinical Psychologist in Saint Louis, Missouri. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5661 Telegraph Rd Ste 4B
Saint Louis, MO 63129-4275
Phone: (860) 788-6404
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X
Social Worker Taxonomy 104100000X
Psychiatry Physician Taxonomy 2084P0800X
Geriatric Psychiatry Physician Taxonomy 2084P0805X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1013416585
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrea Godfrey — Credentialing & Enrollment Manager · (860) 398-6441
NPI enumeratedFebruary 9, 2018
Last updated in NPPESMay 5, 2025
Certification dateMay 5, 2025
Mailing addressPo Box 1595, Middletown, CT 06457-8095

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