| Provident Behavioral Health | |
|
2650 Olive St Saint Louis MO 63103-1424 | |
| (314) 371-6500 | |
| (314) 371-1155 |
| Full Name | Provident Behavioral Health |
|---|---|
| Speciality | Counselor |
| Location | 2650 Olive St, Saint Louis, Missouri |
| Authorized Official Name and Position | Kathy S Schlemmer (RELATIONS COORDINATOR) |
| Authorized Official Contact | 3148022647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Provident Behavioral Health 2650 Olive St Saint Louis MO 63103-1424 Ph: (314) 371-6500 | Provident Behavioral Health 2650 Olive St Saint Louis MO 63103-1424 Ph: (314) 371-6500 |
| NPI Number | 1710023791 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 10/05/2022 |
| Certification Date | 05/18/2021 |
| Medicare PECOS PAC ID | 0345217279 |
|---|---|
| Medicare Enrollment ID | O20050407000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710023791 | NPI | - | NPPES |
| MA5670 | Other | MO | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | () | Secondary |
| Provider Name | Mary C Strauss-barrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740230606 PECOS PAC ID: 0648290767 Enrollment ID: I20051202000655 |
| Provider Name | Tanja M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447654827 PECOS PAC ID: 1254653652 Enrollment ID: I20141212001157 |
| Provider Name | Sarah Elizabeth Cirese-payton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053876292 PECOS PAC ID: 5698014629 Enrollment ID: I20190308000667 |
| Provider Name | Megan E Bax |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336531631 PECOS PAC ID: 5092073023 Enrollment ID: I20200225001389 |
| Provider Name | Courtney Paige Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639796766 PECOS PAC ID: 0143647479 Enrollment ID: I20200901000504 |
| Provider Name | Alexander Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881289510 PECOS PAC ID: 9931516549 Enrollment ID: I20210326001953 |
| Provider Name | Victoria N Griesenauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568945020 PECOS PAC ID: 0042686800 Enrollment ID: I20221019000936 |
| Provider Name | Dayton J Nelsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417670654 PECOS PAC ID: 1254700578 Enrollment ID: I20221208002039 |
| Provider Name | Kelley Runde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942993894 PECOS PAC ID: 6901267111 Enrollment ID: I20230804000543 |
| Provider Name | Karolyn Marie Ratliff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508596461 PECOS PAC ID: 4082061510 Enrollment ID: I20231121003058 |
| Provider Name | Sarah E Paradise |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427594548 PECOS PAC ID: 5799133096 Enrollment ID: I20231128000379 |
| Provider Name | Cynthia a Jung |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073145900 PECOS PAC ID: 0547618878 Enrollment ID: I20231128001552 |
| Provider Name | Samantha Jane Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124613005 PECOS PAC ID: 0042668386 Enrollment ID: I20231128001765 |
| Provider Name | Gabriella Santos Francisco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386262541 PECOS PAC ID: 6800244393 Enrollment ID: I20231128002040 |
| Provider Name | Daniel Michael Dwyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023698982 PECOS PAC ID: 2567810039 Enrollment ID: I20231130000739 |
| Provider Name | Angela Wallace |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417435819 PECOS PAC ID: 1850735150 Enrollment ID: I20240214002965 |
| Provider Name | Brenda Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619535986 PECOS PAC ID: 5991139388 Enrollment ID: I20240424003235 |
| Provider Name | Alexandrea Michelle Ward |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699494781 PECOS PAC ID: 9032652847 Enrollment ID: I20240621001142 |
| Provider Name | Emory Madalyn Endicott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376276774 PECOS PAC ID: 5496286767 Enrollment ID: I20240927001949 |
| Provider Name | Joanna Sigmund |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1962216424 PECOS PAC ID: 5092237040 Enrollment ID: I20250319001092 |
| Provider Name | Brendan Benn Templin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669367348 PECOS PAC ID: 8820590466 Enrollment ID: I20250904001087 |
| Provider Name | Consuelo Maturana |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518483825 PECOS PAC ID: 4385136803 Enrollment ID: I20251122000115 |
| Provider Name | Bridget M Sims |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639878085 PECOS PAC ID: 7517450372 Enrollment ID: I20251202000184 |
| Provider Name | Ashley Wilkinson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437725777 PECOS PAC ID: 8426534405 Enrollment ID: I20260108004161 |
| Provider Name | Nicole R Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922879840 PECOS PAC ID: 9830673748 Enrollment ID: I20260318004145 |
| Provider Name | Karsee Taylor Parr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407860836 PECOS PAC ID: 7214406453 Enrollment ID: I20260515003448 |
The Relationship Center of St. Louis Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7292 Manchester Rd, Saint Louis, MO 63143 Phone: 314-659-8330 Fax: 314-659-8330 |
Express Care Solutions, LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3641 Oakdale Ave, Saint Louis, MO 63121 Phone: 314-727-0453 Fax: 314-727-6067 |
Traveling Heart Therapy LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2200 W Port Plaza Dr Ste 326, Saint Louis, MO 63146 Phone: 636-328-5212 Fax: 636-333-4510 |
Plumeria Stl, Counseling and Consulting Services Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3115 S Grand Blvd Ste 300, Saint Louis, MO 63118 Phone: 314-339-7356 |
Skn PLLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1034 S Brentwood Blvd Ste 555, Saint Louis, MO 63117 Phone: 314-408-2275 |
Luis a Giuffra LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 621 S New Ballas Rd, Suite 398a, Saint Louis, MO 63141 Phone: 314-251-7720 Fax: 314-251-7722 |