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Contact Information

STATE OF MISSOURI
1706 E ELM ST
JEFFERSON CITY, MO65101-4130
 Phone: 573-751-3398
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

103TR0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for STATE OF MISSOURI

NPI # 1578199238
LBN Legal business name STATE OF MISSOURI
Authorized official MOLLY BOECKMANN - (DIRECTOR OF ADMINISTRATIVE SERVICES)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/13/2020
Last updated 10/27/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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