| Mineral Area Psychiatric Services Llc | |
|
203 S Washington St Farmington MO 63640-1836 | |
| (573) 664-1047 | |
| Not Available |
| Full Name | Mineral Area Psychiatric Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 203 S Washington St, Farmington, Missouri |
| Authorized Official Name and Position | Gabriel E Crawford (PMHNP) |
| Authorized Official Contact | 5733306468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mineral Area Psychiatric Services Llc 203 S Washington St Farmington MO 63640-1836 Ph: (573) 664-1047 | Mineral Area Psychiatric Services Llc 203 S Washington St Farmington MO 63640-1836 Ph: (573) 664-1047 |
| NPI Number | 1306379482 |
|---|---|
| Provider Enumeration Date | 04/06/2017 |
| Last Update Date | 08/09/2023 |
| Certification Date | 08/09/2023 |
| Medicare PECOS PAC ID | 3072880962 |
|---|---|
| Medicare Enrollment ID | O20170524002469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306379482 | NPI | - | NPPES |
| 160318081127359 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 103297 (Missouri) | Primary |
| Provider Name | Walter G Barron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518994490 PECOS PAC ID: 5698705143 Enrollment ID: I20050816000037 |
| Provider Name | Robin L Gipson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326053893 PECOS PAC ID: 5395829782 Enrollment ID: I20080225000080 |
| Provider Name | Christina G Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427217116 PECOS PAC ID: 7618044231 Enrollment ID: I20120124000896 |
| Provider Name | Jared R Arnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053703488 PECOS PAC ID: 0345541389 Enrollment ID: I20151217000458 |
| Provider Name | Gabriel Eugene Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730546243 PECOS PAC ID: 8325343957 Enrollment ID: I20160219001054 |
| Provider Name | Andrea L Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376042069 PECOS PAC ID: 9335494574 Enrollment ID: I20180612002333 |
| Provider Name | Harold B Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265071484 PECOS PAC ID: 4880020841 Enrollment ID: I20200211001137 |
| Provider Name | Dustin Morton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164062998 PECOS PAC ID: 0840627733 Enrollment ID: I20200306000255 |
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