| Psych Associates Llc | |
|
1358 E Kingsley St Ste E Springfield MO 65804 | |
| (417) 414-0333 | |
| (417) 268-9114 |
| Full Name | Psych Associates Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1358 E Kingsley St Ste E, Springfield, Missouri |
| Authorized Official Name and Position | Gabriel A Cline (OWNER) |
| Authorized Official Contact | 4174140333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psych Associates Llc 1358 E Kingsley St Ste E Springfield MO 65804-7245 Ph: (417) 414-0333 | Psych Associates Llc 1358 E Kingsley St Ste E Springfield MO 65804 Ph: (417) 414-0333 |
| NPI Number | 1316458441 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 01/04/2022 |
| Certification Date | 01/04/2022 |
| Medicare PECOS PAC ID | 0345515607 |
|---|---|
| Medicare Enrollment ID | O20171012001468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316458441 | NPI | - | NPPES |
| 1558555045 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | 2010006114 (Missouri) | Primary |
| Provider Name | Gabriel A Cline |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558555045 PECOS PAC ID: 0840465571 Enrollment ID: I20111208000355 |
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