| Clay Poplin Lcsw, Llc | |
|
607 Lana Dr Suite C Cameron MO 64429-1392 | |
| (816) 284-2029 | |
| (816) 632-8228 |
| Full Name | Clay Poplin Lcsw, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 607 Lana Dr, Cameron, Missouri |
| Authorized Official Name and Position | Jonathan Clay Poplin (OWNER) |
| Authorized Official Contact | 8162842029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clay Poplin Lcsw, Llc Po Box 392 Cameron MO 64429-0392 Ph: (816) 284-2029 | Clay Poplin Lcsw, Llc 607 Lana Dr Suite C Cameron MO 64429-1392 Ph: (816) 284-2029 |
| NPI Number | 1811217276 |
|---|---|
| Provider Enumeration Date | 06/08/2010 |
| Last Update Date | 07/30/2014 |
| Medicare PECOS PAC ID | 8729103171 |
|---|---|
| Medicare Enrollment ID | O20140925001281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811217276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | NV20101260400 (Nevada) | Primary |
| Provider Name | Jonathan Poplin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538229802 PECOS PAC ID: 6901847011 Enrollment ID: I20140925001334 |
Trinity Professional Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1610 E Grand Ave, Cameron, MO 64429 Phone: 816-425-1382 Fax: 816-343-0530 | |
Cameron Regional Medical Center, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1600 E Evergreen St, Cameron, MO 64429 Phone: 816-632-2101 Fax: 816-649-3833 |