| Bolivar Family Counseling Center Llc | |
|
5438 S 244th Rd Buffalo MO 65622-9373 | |
| (417) 399-4828 | |
| Not Available |
| Full Name | Bolivar Family Counseling Center Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5438 S 244th Rd, Buffalo, Missouri |
| Authorized Official Name and Position | Don Axsom (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 4173994828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolivar Family Counseling Center Llc 5438 S 244th Rd Buffalo MO 65622-9373 Ph: (417) 399-4828 | Bolivar Family Counseling Center Llc 5438 S 244th Rd Buffalo MO 65622-9373 Ph: (417) 399-4828 |
| NPI Number | 1982895595 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 05/17/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982895595 | NPI | - | NPPES |
| 507418903 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2003032059 (Missouri) | Secondary |
| 103T00000X | Psychologist | 2006006562 (Missouri) | Primary |