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

State of Missouri

Organization Psychologist · NPI 1164477873

State of Missouri is a Psychologist in Fulton, Missouri. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
8
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Practice location Address checks out

600 E 5th St
Fulton, MO 65251-1753
Phone: (573) 592-4100
Fax: (573) 592-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X
Psychologist Taxonomy 103T00000X
Clinical Psychologist Taxonomy 103TC0700X
Clinical Social Worker Taxonomy 1041C0700X
Optometrist Taxonomy 152W00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Podiatrist Taxonomy 213E00000X

Record details

NPI number1164477873
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationState of Missouri
Authorized official Molly Boeckmann — Director Of Administrative Services · (573) 751-4055
Other names Fulton State Hospital; Fulton State Hospital
NPI enumeratedMay 23, 2006
Last updated in NPPESAugust 28, 2020
Certification dateAugust 28, 2020
Mailing address1706 E Elm St, Po Box 687, Jefferson City, MO 65101-4130

Other providers in Fulton