| Madmar, Llc | |
|
1215 Fern Ridge Pkwy Ste 110 Saint Louis MO 63141-4405 | |
| (314) 275-8599 | |
| Not Available |
| Full Name | Madmar, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1215 Fern Ridge Pkwy Ste 110, Saint Louis, Missouri |
| Authorized Official Name and Position | Steve Miskovic (OWNER) |
| Authorized Official Contact | 3149717595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Madmar, Llc 1215 Fern Ridge Pkwy Ste 110 Saint Louis MO 63141-4405 Ph: (314) 275-8599 | Madmar, Llc 1215 Fern Ridge Pkwy Ste 110 Saint Louis MO 63141-4405 Ph: (314) 275-8599 |
| NPI Number | 1053152892 |
|---|---|
| Provider Enumeration Date | 06/05/2024 |
| Last Update Date | 06/05/2024 |
| Certification Date | 06/05/2024 |
| Medicare PECOS PAC ID | 8628516119 |
|---|---|
| Medicare Enrollment ID | O20240815000426 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053152892 | NPI | - | NPPES |
| Provider Name | Mary C Fitzgibbons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679752562 PECOS PAC ID: 1951595925 Enrollment ID: I20101103001006 |
| Provider Name | Amy Kelly Neu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033531207 PECOS PAC ID: 5294966263 Enrollment ID: I20140317001040 |
| Provider Name | Steven J Miskovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649688854 PECOS PAC ID: 2264651413 Enrollment ID: I20140919001729 |
| Provider Name | Murisa Begic-gusic |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184962623 PECOS PAC ID: 2365663606 Enrollment ID: I20141029002400 |
| Provider Name | Bryan C Duckham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063804821 PECOS PAC ID: 1658698618 Enrollment ID: I20150331002898 |
| Provider Name | Angela C Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255409140 PECOS PAC ID: 9830404284 Enrollment ID: I20150814013184 |
| Provider Name | Jessica L Dollar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578208575 PECOS PAC ID: 3577940980 Enrollment ID: I20220524000975 |
| Provider Name | Theresa F Wiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780369405 PECOS PAC ID: 6901265198 Enrollment ID: I20230706001908 |
| Provider Name | Julia F Covilli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902475718 PECOS PAC ID: 5991236564 Enrollment ID: I20241007002657 |
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