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

State of Missouri

Organization Psychiatry Physician · NPI 1114971702

State of Missouri is a Psychiatry Physician in Nevada, Missouri. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2

Practice location Address checks out

2323 N Ash St
Nevada, MO 64772-1054
Phone: (417) 667-7833
Fax: (417) 448-1138
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1114971702
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of Missouri
Authorized official Molly Boeckmann — Director Of Administrative Services · (573) 751-4055
Other names Nevada Habilitation Center; Nevada Habilitation Center
NPI enumeratedMay 19, 2006
Last updated in NPPESAugust 26, 2020
Certification dateAugust 26, 2020
Mailing address1706 E Elm St, Jefferson City, MO 65101-4130

Other providers in Nevada