| Capital Region Physicians - Center For Mental Wellness | |
|
1432 Southwest Blvd Jefferson City MO 65109-2444 | |
| (573) 632-5560 | |
| (573) 632-5875 |
| Full Name | Capital Region Physicians - Center For Mental Wellness |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1432 Southwest Blvd, Jefferson City, Missouri |
| Authorized Official Name and Position | Tom Luebbering (VP OF FINANCE) |
| Authorized Official Contact | 5736325100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Region Physicians - Center For Mental Wellness 1432 Southwest Blvd Po Box 1128 Jefferson City MO 65109-2444 Ph: (573) 632-5560 | Capital Region Physicians - Center For Mental Wellness 1432 Southwest Blvd Jefferson City MO 65109-2444 Ph: (573) 632-5560 |
| NPI Number | 1326234733 |
|---|---|
| Provider Enumeration Date | 09/19/2007 |
| Last Update Date | 08/23/2013 |
| Medicare PECOS PAC ID | 4688573686 |
|---|---|
| Medicare Enrollment ID | O20071101000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326234733 | NPI | - | NPPES |
| 505995001 | Medicaid | MO |
| Provider Name | Ann M Pollock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124109079 PECOS PAC ID: 1254345424 Enrollment ID: I20060127000043 |
| Provider Name | Heather Mcbee Johns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639287915 PECOS PAC ID: 4880867548 Enrollment ID: I20111026000075 |
| Provider Name | Wesley Clifford Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053714154 PECOS PAC ID: 9931320306 Enrollment ID: I20141028002156 |
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