| Proactive Behavioral Health Solutions, Inc. | |
|
1654 Bryan Rd O Fallon MO 63368-4897 | |
| (636) 344-0433 | |
| Not Available |
| Full Name | Proactive Behavioral Health Solutions, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1654 Bryan Rd, O Fallon, Missouri |
| Authorized Official Name and Position | Ryan W Morris (PRESIDENT) |
| Authorized Official Contact | 2172427718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Behavioral Health Solutions, Inc. 6389 Highway C Palmyra MO 63461-2044 Ph: (217) 242-7718 | Proactive Behavioral Health Solutions, Inc. 1654 Bryan Rd O Fallon MO 63368-4897 Ph: (636) 344-0433 |
| NPI Number | 1952137861 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 04/04/2025 |
| Certification Date | 04/04/2025 |
| Medicare PECOS PAC ID | 1658801394 |
|---|---|
| Medicare Enrollment ID | O20250210002677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952137861 | NPI | - | NPPES |
| Provider Name | Tracy Ann Cushing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881917342 PECOS PAC ID: 4183758139 Enrollment ID: I20100813000052 |
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