| Psychological Services Of St. Louis, Llc | |
|
7110 Oakland Ave Suite 105 Richmond Heights MO 63117-1868 | |
| (314) 884-0779 | |
| (314) 227-9327 |
| Full Name | Psychological Services Of St. Louis, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 7110 Oakland Ave, Richmond Heights, Missouri |
| Authorized Official Name and Position | Gregory A Goldman (CO-OWNER) |
| Authorized Official Contact | 3148848075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Services Of St. Louis, Llc 7110 Oakland Ave Suite 105 Richmond Heights MO 63117-1868 Ph: (314) 884-0779 | Psychological Services Of St. Louis, Llc 7110 Oakland Ave Suite 105 Richmond Heights MO 63117-1868 Ph: (314) 884-0779 |
| NPI Number | 1841743317 |
|---|---|
| Provider Enumeration Date | 08/01/2016 |
| Last Update Date | 08/01/2016 |
| Medicare PECOS PAC ID | 9436404837 |
|---|---|
| Medicare Enrollment ID | O20180625003583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841743317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2010030791 (Missouri) | Primary |
| Provider Name | Gregory A Goldman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952634347 PECOS PAC ID: 6002931524 Enrollment ID: I20100921000164 |
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