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Contact Information

COMMUNITY AND LONG-TERM CARE PSYCHIATRY LLC
10004 KENNERLY RD STE 362B
SAINT LOUIS, MO63128-2178
 Phone: 314-525-5050
 Fax: 314-525-5072
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Psychosomatic Medicine

2084P0015X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for COMMUNITY AND LONG TERM CARE PSYCHIATRY LLC · (Female)

NPI # 1699121475
Status Active
Credentials
Entity Individual
Enumeration date 05/10/2016
Last updated 01/17/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # 2015002634
  • MO Medicaid 1265723407
  • MO Other 156440095 MEDICARE
  • MO Other P01585490 RR MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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