| River Rock Behavioral Health, Llc | |
|
777 S New Ballas Rd Ste 129w Saint Louis MO 63141-8745 | |
| (314) 408-7676 | |
| (314) 328-5453 |
| Full Name | River Rock Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 777 S New Ballas Rd Ste 129w, Saint Louis, Missouri |
| Authorized Official Name and Position | Jessica Harvath (OWNER) |
| Authorized Official Contact | 3144087676 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Rock Behavioral Health, Llc 50 Crestwood Executive Ctr Ste 308 Saint Louis MO 63126-1900 Ph: (314) 408-7676 | River Rock Behavioral Health, Llc 777 S New Ballas Rd Ste 129w Saint Louis MO 63141-8745 Ph: (314) 408-7676 |
| NPI Number | 1376157453 |
|---|---|
| Provider Enumeration Date | 09/04/2020 |
| Last Update Date | 04/28/2023 |
| Certification Date | 04/28/2023 |
| Medicare PECOS PAC ID | 7810317609 |
|---|---|
| Medicare Enrollment ID | O20201016000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376157453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Jessica L Harvath |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699143412 PECOS PAC ID: 8022374677 Enrollment ID: I20171114003281 |
| Provider Name | Jordan Kelley Howell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386069698 PECOS PAC ID: 0648637496 Enrollment ID: I20230609000140 |
| Provider Name | Sarah Nicole Brewer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679143242 PECOS PAC ID: 8527417518 Enrollment ID: I20231215003125 |
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