| Bjc Behavioral Health | |
|
1085 Maple St Farmington MO 63640-1955 | |
| (573) 756-5353 | |
| Not Available |
| Full Name | Bjc Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 1085 Maple St, Farmington, Missouri |
| Authorized Official Name and Position | Angela Martin-davis (PRESIDENT) |
| Authorized Official Contact | 3142063712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bjc Behavioral Health 3309 S Kingshighway Blvd Saint Louis MO 63139-1101 Ph: (314) 206-3700 | Bjc Behavioral Health 1085 Maple St Farmington MO 63640-1955 Ph: (573) 756-5353 |
| NPI Number | 1801807847 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Medicare PECOS PAC ID | 1153225271 |
|---|---|
| Medicare Enrollment ID | O20040414000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801807847 | NPI | - | NPPES |
| 154902019 | Medicaid | MO | |
| 876175803 | Medicaid | MO | |
| 154902001 | Medicaid | MO | |
| 7107617 | Other | MO DEPT OF MENTAL HEALTH | |
| 876175811 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 267-7258 (Missouri) | Primary |
| Provider Name | Veera N Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336257237 PECOS PAC ID: 1557256583 Enrollment ID: I20040218000955 |
| Provider Name | Eileen Ai-ling Wu-evans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881741825 PECOS PAC ID: 2668360827 Enrollment ID: I20040309000535 |
| Provider Name | Muhammad Baber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497769194 PECOS PAC ID: 3476518200 Enrollment ID: I20041122000346 |
| Provider Name | Theresa J Villaflores |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609923689 PECOS PAC ID: 7517916653 Enrollment ID: I20050117000013 |
| Provider Name | William N Letterman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578577193 PECOS PAC ID: 5799884987 Enrollment ID: I20070629000071 |
| Provider Name | Jessica M Woolf-chessey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144414731 PECOS PAC ID: 5395839195 Enrollment ID: I20070925000246 |
| Provider Name | Denise Troy Curry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891786406 PECOS PAC ID: 2567538325 Enrollment ID: I20080903000253 |
| Provider Name | Christina A Rariden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881854354 PECOS PAC ID: 1254490568 Enrollment ID: I20081031000203 |
| Provider Name | Gautam Rohatgi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710065024 PECOS PAC ID: 3971667957 Enrollment ID: I20090206000034 |
| Provider Name | Thomas W Freeman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801999289 PECOS PAC ID: 2365509676 Enrollment ID: I20090914000062 |
| Provider Name | Donald D Bohnenkamp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316139116 PECOS PAC ID: 4082892740 Enrollment ID: I20110628000326 |
| Provider Name | Akinkunle Owoso |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063610319 PECOS PAC ID: 7012186281 Enrollment ID: I20110803000805 |
| Provider Name | Mark S Corman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942332267 PECOS PAC ID: 5294803029 Enrollment ID: I20120117000097 |
| Provider Name | Christina G Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427217116 PECOS PAC ID: 7618044231 Enrollment ID: I20120124000896 |
| Provider Name | Christine M Black |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073814828 PECOS PAC ID: 1850551532 Enrollment ID: I20120404000876 |
| Provider Name | Subhash Bashyal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811126337 PECOS PAC ID: 9537393004 Enrollment ID: I20131016001436 |
| Provider Name | David B Liss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821385899 PECOS PAC ID: 5092943928 Enrollment ID: I20150116001942 |
| Provider Name | Laura A Shapiro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750395323 PECOS PAC ID: 5799086708 Enrollment ID: I20151216002589 |
| Provider Name | Eric N Wittrock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619265865 PECOS PAC ID: 2264660174 Enrollment ID: I20160607001317 |
| Provider Name | Tianyuan Yin Cornell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942644349 PECOS PAC ID: 0042526204 Enrollment ID: I20171128000735 |
| Provider Name | Kelly E Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447273933 PECOS PAC ID: 9234102856 Enrollment ID: I20180719003033 |
| Provider Name | Kristen M Kellerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700340205 PECOS PAC ID: 1557601234 Enrollment ID: I20190315000512 |
| Provider Name | Amy L Salzer Bothmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376787192 PECOS PAC ID: 3870835010 Enrollment ID: I20190508002071 |
| Provider Name | Celsius-kit Gesmundo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558654053 PECOS PAC ID: 0941513626 Enrollment ID: I20190517000634 |
| Provider Name | Amy M Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851936736 PECOS PAC ID: 4688008303 Enrollment ID: I20200103002410 |
| Provider Name | Mildred E Fortune-gilpin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013930403 PECOS PAC ID: 7517396302 Enrollment ID: I20200330002492 |
| Provider Name | Brian Hd Bui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699152249 PECOS PAC ID: 9537475637 Enrollment ID: I20200721002445 |
| Provider Name | Tammy Christopher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770672495 PECOS PAC ID: 8426476359 Enrollment ID: I20200909002727 |
| Provider Name | Oliver J Yost |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629160478 PECOS PAC ID: 8628170743 Enrollment ID: I20211109001493 |
| Provider Name | Nancy Gale Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285301721 PECOS PAC ID: 1052717667 Enrollment ID: I20220802000927 |
| Provider Name | Ebony Brabham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063747772 PECOS PAC ID: 4789066101 Enrollment ID: I20220802001898 |
| Provider Name | Andria M Silver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003562158 PECOS PAC ID: 5799150421 Enrollment ID: I20230412000680 |
| Provider Name | Darin Chia Fay Quach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679068761 PECOS PAC ID: 9931566692 Enrollment ID: I20230612001380 |
| Provider Name | Anatoliy Kuznetsov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265937080 PECOS PAC ID: 9234524703 Enrollment ID: I20230612001643 |
| Provider Name | Sarah Berg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972023570 PECOS PAC ID: 5193056166 Enrollment ID: I20230705000804 |
| Provider Name | Danita T Flakes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083159594 PECOS PAC ID: 0143680405 Enrollment ID: I20230718002422 |
| Provider Name | Shannon R Mcguire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134780471 PECOS PAC ID: 3274869284 Enrollment ID: I20230906001390 |
| Provider Name | Lewis Li Tian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942769856 PECOS PAC ID: 1456686203 Enrollment ID: I20230913000760 |
| Provider Name | Molly K Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700892403 PECOS PAC ID: 9739533530 Enrollment ID: I20230927003927 |
| Provider Name | Sofia Y Daneshyar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306509492 PECOS PAC ID: 2062863046 Enrollment ID: I20240104001472 |
| Provider Name | James Keeton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730565086 PECOS PAC ID: 6305297284 Enrollment ID: I20240104001998 |
| Provider Name | Stephanie Weatherspoon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073046850 PECOS PAC ID: 2365886769 Enrollment ID: I20240213003862 |
| Provider Name | Leslie D Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477080539 PECOS PAC ID: 9830533603 Enrollment ID: I20240220002887 |
| Provider Name | Courtney Winters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841823689 PECOS PAC ID: 6709221013 Enrollment ID: I20240227000688 |
| Provider Name | Kelly J Brotherton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740294750 PECOS PAC ID: 8022453349 Enrollment ID: I20240227000906 |
| Provider Name | Brenda M Brady |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073557989 PECOS PAC ID: 0547154478 Enrollment ID: I20240229003354 |
| Provider Name | Jessica L Wells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083996037 PECOS PAC ID: 9830534494 Enrollment ID: I20240305002699 |
| Provider Name | Sarah N Bauer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063429405 PECOS PAC ID: 8527404318 Enrollment ID: I20240315000427 |
| Provider Name | Sarah A Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154477149 PECOS PAC ID: 8729427919 Enrollment ID: I20240422000334 |
| Provider Name | Amanda Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710765540 PECOS PAC ID: 9537508601 Enrollment ID: I20240423000364 |
| Provider Name | Patrick Allen Wheeler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932872272 PECOS PAC ID: 7214377035 Enrollment ID: I20240426002171 |
| Provider Name | Lisa L Cashion |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942375308 PECOS PAC ID: 7719328533 Enrollment ID: I20240510002433 |
| Provider Name | Salman Ahsan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649768375 PECOS PAC ID: 2860739992 Enrollment ID: I20240727000366 |
| Provider Name | Miya Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790247310 PECOS PAC ID: 9830424118 Enrollment ID: I20240806003517 |
| Provider Name | Y'manni Mayo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548910961 PECOS PAC ID: 0941748594 Enrollment ID: I20240814003726 |
| Provider Name | Michael Eugene Kalinowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497769418 PECOS PAC ID: 5092254276 Enrollment ID: I20240903000102 |
| Provider Name | Nan Zhao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326675158 PECOS PAC ID: 4789006248 Enrollment ID: I20240909000223 |
| Provider Name | Vincent G Mazzoccoli |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538814066 PECOS PAC ID: 6002356763 Enrollment ID: I20240909002119 |
| Provider Name | David Paul Boyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831824036 PECOS PAC ID: 5597206953 Enrollment ID: I20240925002544 |
| Provider Name | Dawn V Ortega |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205251378 PECOS PAC ID: 9739620071 Enrollment ID: I20240926000845 |
| Provider Name | Robert R Vandermyde |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689345951 PECOS PAC ID: 7113468406 Enrollment ID: I20240926002836 |
| Provider Name | Veronica Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104178433 PECOS PAC ID: 2163966805 Enrollment ID: I20241029002476 |
| Provider Name | Eva Kolb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750724951 PECOS PAC ID: 9133491772 Enrollment ID: I20250317003022 |
| Provider Name | Tasha Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811651805 PECOS PAC ID: 8123543279 Enrollment ID: I20250422000585 |
| Provider Name | Tamatha L. Markowski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770630204 PECOS PAC ID: 7315463130 Enrollment ID: I20250424002474 |
| Provider Name | Jessie Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043990864 PECOS PAC ID: 5890211478 Enrollment ID: I20250428000447 |
| Provider Name | Casey Robinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194201509 PECOS PAC ID: 2769908342 Enrollment ID: I20250428000569 |
| Provider Name | Eleanor Warshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801460944 PECOS PAC ID: 4486170016 Enrollment ID: I20250428001721 |
| Provider Name | Tiera C Dunning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518783901 PECOS PAC ID: 4880111350 Enrollment ID: I20250508000249 |
Southeast Missouri Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Hwy 32, Farmington, MO 63640 Phone: 573-756-5749 Fax: 573-431-5205 | |
Womack Counseling Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 503 Potosi St, Farmington, MO 63640 Phone: 573-756-1602 Fax: 573-756-1603 | |
Bjc Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1085 Maple Street, Farmington, MO 63640 Phone: 573-756-5353 Fax: 573-756-4557 | |
T-k Ranch Equine Assisted Coaching Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17885 Hart Pinkston Rd, Farmington, MO 63640 Phone: 573-747-9115 Fax: 855-209-5615 | |
Bjc Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1085 Maple St, Farmington, MO 63640 Phone: 573-756-5353 | |
Bjc Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1085 Maple St, Farmington, MO 63640 Phone: 573-756-5353 Fax: 573-756-4557 | |
Southeast Missouri Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 State Highway 32, Po Drawer 459, Farmington, MO 63640 Phone: 573-756-5749 Fax: 573-756-7451 |