| Residential Psychiatric Services, Inc. | |
|
1269 Doctors Dr Farmington MO 63640-2947 | |
| (573) 664-1146 | |
| (573) 664-1149 |
| Full Name | Residential Psychiatric Services, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 1269 Doctors Dr, Farmington, Missouri |
| Authorized Official Name and Position | Mona Kay Evans (PRESIDENT) |
| Authorized Official Contact | 5737834292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential Psychiatric Services, Inc. 1269 Doctors Dr Farmington MO 63640-2947 Ph: (573) 664-1146 | Residential Psychiatric Services, Inc. 1269 Doctors Dr Farmington MO 63640-2947 Ph: (573) 664-1146 |
| NPI Number | 1467453894 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 08/29/2016 |
| Medicare PECOS PAC ID | 3870576390 |
|---|---|
| Medicare Enrollment ID | O20040608000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467453894 | NPI | - | NPPES |
| 850830902 | Other | MO | DMH |
| 500830906 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 002060 (Missouri) | Primary |
| Provider Name | Mona K Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407886864 PECOS PAC ID: 7719960236 Enrollment ID: I20040608000003 |
| Provider Name | Stefani J Poelker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184694671 PECOS PAC ID: 8426018961 Enrollment ID: I20041019000136 |
| Provider Name | Joetta R Douty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295054021 PECOS PAC ID: 3678503745 Enrollment ID: I20050818000137 |
| Provider Name | Debra L Wyatt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962493221 PECOS PAC ID: 0840200333 Enrollment ID: I20060427000663 |
| Provider Name | Michelle L Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336155613 PECOS PAC ID: 7315045077 Enrollment ID: I20070605000196 |
| Provider Name | Carla S Schumacher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912110842 PECOS PAC ID: 5294803086 Enrollment ID: I20081007000212 |
| Provider Name | Jennifer L Sansone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306098918 PECOS PAC ID: 4082773585 Enrollment ID: I20081112000246 |
| Provider Name | Karen L Monroe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457564023 PECOS PAC ID: 5597893834 Enrollment ID: I20100507000196 |
| Provider Name | Carol Ruth Childers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396993275 PECOS PAC ID: 3476748898 Enrollment ID: I20101111000481 |
| Provider Name | Sarah L Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083920599 PECOS PAC ID: 2365637279 Enrollment ID: I20101117000208 |
| Provider Name | Larry G Lacey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437334729 PECOS PAC ID: 4688997810 Enrollment ID: I20141219000969 |
| Provider Name | Tasha L Wisdom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730450156 PECOS PAC ID: 6608193651 Enrollment ID: I20150331002659 |
| Provider Name | Deborah L Bonham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023497468 PECOS PAC ID: 5395066195 Enrollment ID: I20150604002610 |
| Provider Name | Shawn P Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326376260 PECOS PAC ID: 6507144748 Enrollment ID: I20161024000969 |
| Provider Name | Daniel A Murray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902111388 PECOS PAC ID: 0345479929 Enrollment ID: I20161208001208 |
| Provider Name | Joanna T Dalakos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801193396 PECOS PAC ID: 6002156551 Enrollment ID: I20190319002551 |
| Provider Name | Erica L Wofford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619981040 PECOS PAC ID: 8022446046 Enrollment ID: I20200325000556 |
| Provider Name | Georgia L Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073146957 PECOS PAC ID: 2668800681 Enrollment ID: I20200325000569 |
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