| Midwest Psychiatry | |
|
4219 Laclede Ave Saint Louis MO 63108-2814 | |
| (314) 880-5415 | |
| (314) 880-5468 |
| Full Name | Midwest Psychiatry |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 4219 Laclede Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Patricia Holmes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3148805415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Psychiatry 4245 Forest Park Ave Saint Louis MO 63108-2810 Ph: (314) 880-5415 | Midwest Psychiatry 4219 Laclede Ave Saint Louis MO 63108-2814 Ph: (314) 880-5415 |
| NPI Number | 1083054787 |
|---|---|
| Provider Enumeration Date | 06/27/2013 |
| Last Update Date | 06/27/2022 |
| Certification Date | 06/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083054787 | NPI | - | NPPES |
| 560003943 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Missouri) | Primary |
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