| Applied Psychological Center, Llc | |
|
2907 Independence St Suite F Cape Girardeau MO 63703-5044 | |
| (573) 334-3329 | |
| (573) 200-7006 |
| Full Name | Applied Psychological Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2907 Independence St, Cape Girardeau, Missouri |
| Authorized Official Name and Position | David M Van Pelt (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5733343329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Applied Psychological Center, Llc 2907 Independence St Suite F Cape Girardeau MO 63703-5044 Ph: (573) 334-3329 | Applied Psychological Center, Llc 2907 Independence St Suite F Cape Girardeau MO 63703-5044 Ph: (573) 334-3329 |
| NPI Number | 1003018417 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 02/10/2014 |
| Medicare PECOS PAC ID | 2961418496 |
|---|---|
| Medicare Enrollment ID | O20060221000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003018417 | NPI | - | NPPES |
| 506277102 | Medicaid | MO | |
| 001976787 | Other | MO | CHILD TREATMENT SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Missouri) | Primary |
| Provider Name | David M Van Pelt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821066242 PECOS PAC ID: 0749296283 Enrollment ID: I20060223000075 |
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