State of Missouri
State of Missouri is a Clinical Psychologist in Farmington, Missouri. Registered with an NPI since 2006.
- In the registry since
- 2006
- Specialties on file
- 4
Practice location Address checks out
1010 W Columbia StFarmington, MO 63640-2902
Phone: (573) 218-6792
Fax: (573) 218-6703
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatry Physician (primary) | Taxonomy 2084P0800X |
|---|---|
| Clinical Psychologist | Taxonomy 103TC0700X |
| Clinical Social Worker | Taxonomy 1041C0700X |
| General Practice Physician | Taxonomy 208D00000X |
Record details
| NPI number | 1437106705 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | State of Missouri |
| Authorized official | Molly Boeckmann — Director Administrative Services · (573) 751-4055 |
| Other names | Southeast Mo Mental Health Center; Southeast Mo Mental Health Center |
| NPI enumerated | May 30, 2006 |
| Last updated in NPPES | September 3, 2020 |
| Certification date | September 3, 2020 |
| Mailing address | 1706 E Elm St, Jefferson City, MO 65101-4130 |
Other providers in Farmington
-
Dr. Lavaughn Brathwaite, PSYD
1016 W Columbia St, Farmington, MO 63640-2902 · (573) 747-2231
-
Kelly Duron
1016 W Columbia St, Farmington, MO 63640-2902 · (573) 218-6120
-
Dr. Michael Martin Luther Krownapple, PSYD
1010 W Columbia St, Farmington, MO 63640-2902 · (573) 218-6040
-
Dr. Pamela Renne Wallen, PSYD
1580 W Columbia St, Farmington, MO 63640-3512 · (573) 760-1365
-
Dr. Angela Marie Webb, PSYD
212 W Columbia St Ste B, Farmington, MO 63640-1700 · (573) 315-3800