| North Central Missouri Mental Health Center | |
|
1601 E 28th St Trenton MO 64683-1178 | |
| (660) 359-4487 | |
| (660) 359-2958 |
| Full Name | North Central Missouri Mental Health Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1601 E 28th St, Trenton, Missouri |
| Authorized Official Name and Position | Loryne D. Irvine (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6603594487 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Central Missouri Mental Health Center Po Box 30 Trenton MO 64683-0030 Ph: (660) 359-4487 | North Central Missouri Mental Health Center 1601 E 28th St Trenton MO 64683-1178 Ph: (660) 359-4487 |
| NPI Number | 1730258930 |
|---|---|
| Provider Enumeration Date | 11/06/2006 |
| Last Update Date | 12/18/2020 |
| Certification Date | 12/18/2020 |
| Medicare PECOS PAC ID | 5092766204 |
|---|---|
| Medicare Enrollment ID | O20050204000544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730258930 | NPI | - | NPPES |
| 21371013 | Other | BLUE CROSS BLUE SHIELD | |
| 563012905 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 215-7709 (Missouri) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jane M Wilmes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710910955 PECOS PAC ID: 4587636519 Enrollment ID: I20040810001332 |
| Provider Name | Suzanne King |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760469977 PECOS PAC ID: 7416906748 Enrollment ID: I20050113000699 |
| Provider Name | Kenneth D Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740378785 PECOS PAC ID: 0941225452 Enrollment ID: I20051013000059 |
| Provider Name | Arjumand Jaffri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205976602 PECOS PAC ID: 4688723729 Enrollment ID: I20090521000015 |
| Provider Name | Jan L Altiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336478601 PECOS PAC ID: 7911199856 Enrollment ID: I20101011000153 |
| Provider Name | Barbara S Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730418807 PECOS PAC ID: 5496925919 Enrollment ID: I20110818000920 |
| Provider Name | Thomas Knutson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003109745 PECOS PAC ID: 1759684939 Enrollment ID: I20160121001681 |
| Provider Name | Sherri L Plowman-mullikin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811381031 PECOS PAC ID: 4789959172 Enrollment ID: I20171011001792 |
| Provider Name | Connie J Heaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811366743 PECOS PAC ID: 5496013914 Enrollment ID: I20171211001109 |
| Provider Name | Uraina J Domon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255709606 PECOS PAC ID: 7517229412 Enrollment ID: I20180312001929 |
| Provider Name | Alison J Cornell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225583768 PECOS PAC ID: 8921342742 Enrollment ID: I20181205002984 |
| Provider Name | Fiordaliza Pena-sandoval |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942611983 PECOS PAC ID: 0143628503 Enrollment ID: I20211015000350 |
| Provider Name | Linda Daniel-dim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962174896 PECOS PAC ID: 6406245612 Enrollment ID: I20211109003096 |
| Provider Name | Maeanne Irene Browning |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508175373 PECOS PAC ID: 6002269289 Enrollment ID: I20240124003951 |
| Provider Name | Craig Clinton Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467016501 PECOS PAC ID: 9638513773 Enrollment ID: I20240216003056 |
North Central Missouri Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 28th St, Trenton, MO 64683 Phone: 660-359-4487 Fax: 660-359-4129 | |
North Central Missouri Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 28th St, Trenton, MO 64683 Phone: 660-359-4487 Fax: 660-359-4129 | |
North Central Missouri Children's Advocacy Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 906 Main St, Trenton, MO 64683 Phone: 660-359-2874 Fax: 660-359-2837 | |
North Central Missouri Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 28th St, Trenton, MO 64683 Phone: 660-359-4487 Fax: 660-359-2958 | |
North Central Missouri Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 28th St, Trenton, MO 64683 Phone: 660-359-4487 Fax: 660-359-4129 | |
86 & 87 Waiver/ncmmhc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 28th St, Trenton, MO 64683 Phone: 660-359-4487 Fax: 660-359-2958 | |
North Central Missouri Mental Health Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 28th St, Trenton, MO 64683 Phone: 660-359-4487 Fax: 660-359-4129 |