| Eight Domains Therapy, LLC | |
|
1500 Fellows Pl Apt 3c Columbia MO 65201-8529 | |
| (573) 212-4456 | |
| (573) 970-3007 |
| Full Name | Eight Domains Therapy, LLC |
|---|---|
| Speciality | Social Worker |
| Location | 1500 Fellows Pl Apt 3c, Columbia, Missouri |
| Authorized Official Name and Position | Amber Liponoga (OWNER) |
| Authorized Official Contact | 5732124456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eight Domains Therapy, LLC 115 Conley Rd # 1032 Columbia MO 65201-6465 Ph: (573) 212-4456 | Eight Domains Therapy, LLC 1500 Fellows Pl Apt 3c Columbia MO 65201-8529 Ph: (573) 212-4456 |
| NPI Number | 1730767542 |
|---|---|
| Provider Enumeration Date | 04/01/2021 |
| Last Update Date | 03/31/2025 |
| Certification Date | 03/31/2025 |
| Medicare PECOS PAC ID | 8022507672 |
|---|---|
| Medicare Enrollment ID | O20251103000353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730767542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
| Provider Name | Amber Liponoga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639763147 PECOS PAC ID: 2365819547 Enrollment ID: I20221031002647 |
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