| Ssm Health Medical Group - Behavioral Health | |
|
2701 West Edgewood Suite 101 Jefferson City MO 65109 | |
| (573) 634-5303 | |
| (573) 761-6888 |
| Full Name | Ssm Health Medical Group - Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 2701 West Edgewood, Jefferson City, Missouri |
| Authorized Official Name and Position | Garrick Elliott Mueller (CFO) |
| Authorized Official Contact | 4052807582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ssm Health Medical Group - Behavioral Health Po Box 1027 Jefferson City MO 65102-1027 Ph: (573) 681-3767 | Ssm Health Medical Group - Behavioral Health 2701 West Edgewood Suite 101 Jefferson City MO 65109 Ph: (573) 634-5303 |
| NPI Number | 1053368159 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 09/15/2020 |
| Certification Date | 09/15/2020 |
| Medicare PECOS PAC ID | 8921917352 |
|---|---|
| Medicare Enrollment ID | O20050627000074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053368159 | NPI | - | NPPES |
| 502680002 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Laurel A Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538105986 PECOS PAC ID: 2062485766 Enrollment ID: I20040819000228 |
| Provider Name | Bhaskar Y Gowda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750367967 PECOS PAC ID: 7416910849 Enrollment ID: I20041108000226 |
| Provider Name | Patricia A Alewel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740266345 PECOS PAC ID: 7618925694 Enrollment ID: I20050106000261 |
| Provider Name | Malik Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770557985 PECOS PAC ID: 5294752648 Enrollment ID: I20051026000073 |
| Provider Name | Vincent N Nwankwo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386904787 PECOS PAC ID: 8820300544 Enrollment ID: I20150708002242 |
| Provider Name | Nicole Borrenpohl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235473380 PECOS PAC ID: 0446404743 Enrollment ID: I20160106002832 |
| Provider Name | Swarnalatha Yerrapu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366720385 PECOS PAC ID: 9335424977 Enrollment ID: I20170323000202 |
| Provider Name | Thomas Milam |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669457677 PECOS PAC ID: 5294727889 Enrollment ID: I20180926002502 |
| Provider Name | Mark Schuchman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467517300 PECOS PAC ID: 2961683487 Enrollment ID: I20190617001710 |
| Provider Name | Chen-wen Heh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467449629 PECOS PAC ID: 6507885670 Enrollment ID: I20190617002326 |
| Provider Name | Marie Didario |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740591304 PECOS PAC ID: 3678700291 Enrollment ID: I20190830001827 |
| Provider Name | Maura Munoz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720407364 PECOS PAC ID: 8729206529 Enrollment ID: I20210714002698 |
| Provider Name | Karisa Harpe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629304050 PECOS PAC ID: 2567501463 Enrollment ID: I20211209001680 |
| Provider Name | Joshua W Foster |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700447190 PECOS PAC ID: 4284969973 Enrollment ID: I20211210000752 |
| Provider Name | Joel Saeger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306405717 PECOS PAC ID: 3971837816 Enrollment ID: I20211213000412 |
| Provider Name | Brian Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336461813 PECOS PAC ID: 3072644228 Enrollment ID: I20220224000112 |
| Provider Name | Julie A Tenbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164417606 PECOS PAC ID: 6709876279 Enrollment ID: I20220322001106 |
| Provider Name | Carol Wiediger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033285242 PECOS PAC ID: 2567546773 Enrollment ID: I20220322001114 |
| Provider Name | Nicholas Crall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316262645 PECOS PAC ID: 3274761333 Enrollment ID: I20220511001011 |
| Provider Name | Kofoworola Ojo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942658075 PECOS PAC ID: 4981000262 Enrollment ID: I20220513001596 |
| Provider Name | Sabo Uba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106873 PECOS PAC ID: 4385889849 Enrollment ID: I20220603002295 |
| Provider Name | Pedro Bauza-feliciano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104135128 PECOS PAC ID: 7810114840 Enrollment ID: I20220914001092 |
| Provider Name | Sophie C Feller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134514540 PECOS PAC ID: 0446580260 Enrollment ID: I20221027001954 |
| Provider Name | Katlin E Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487168662 PECOS PAC ID: 2466713474 Enrollment ID: I20221220001093 |
| Provider Name | Janette Coelho Leal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992090708 PECOS PAC ID: 4981844305 Enrollment ID: I20230128000105 |
| Provider Name | Solange Marie Marcel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679602536 PECOS PAC ID: 9335200153 Enrollment ID: I20230316000548 |
| Provider Name | Sherifat I Forcey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043861438 PECOS PAC ID: 8022442235 Enrollment ID: I20230509001865 |
| Provider Name | Denise J White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477624294 PECOS PAC ID: 4880921667 Enrollment ID: I20230510001850 |
| Provider Name | Dorothy S Kozakowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588909196 PECOS PAC ID: 7113160847 Enrollment ID: I20230602001333 |
| Provider Name | Kodjovi Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20230615000284 |
| Provider Name | Donald L Pierce |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790197523 PECOS PAC ID: 4880811264 Enrollment ID: I20230804000500 |
| Provider Name | Jose Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669086641 PECOS PAC ID: 4183043383 Enrollment ID: I20230807000610 |
| Provider Name | Doris Elliott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275570863 PECOS PAC ID: 3375993934 Enrollment ID: I20231221003007 |
| Provider Name | James Marion Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891048799 PECOS PAC ID: 8527418193 Enrollment ID: I20231221003158 |
| Provider Name | Tiffany George |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457888901 PECOS PAC ID: 6901257880 Enrollment ID: I20240104002181 |
| Provider Name | Beth A Berhorst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962624395 PECOS PAC ID: 7416308614 Enrollment ID: I20240112000447 |
| Provider Name | Chrystala Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942778485 PECOS PAC ID: 2961854633 Enrollment ID: I20240118000544 |
| Provider Name | Rodney James Snodgrass Deaton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003934274 PECOS PAC ID: 8921240425 Enrollment ID: I20240208002626 |
Capital Region Physicians - Neurology Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1125 Madison St, Jefferson City, MO 65101 Phone: 573-632-5666 Fax: 573-632-5859 | |
Allcare Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1303 Edgewood Dr, Suite 3a, Jefferson City, MO 65109 Phone: 573-636-0025 Fax: 573-636-0025 | |
Lighthouse Of Hope & Healing, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1026 Northeast Dr Ste B, Jefferson City, MO 65109 Phone: 573-690-7919 Fax: 573-636-7771 | |
Sunrise Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1808a Southwest Blvd, Jefferson City, MO 65109 Phone: 573-619-9387 | |
Marissa R Abbott Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 919 Wildwood Dr, Suite 104, Jefferson City, MO 65109 Phone: 573-635-9654 Fax: 573-635-4466 | |
Lifesong For Growth And Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3401 W Truman Blvd, Ste 100, Jefferson City, MO 65109 Phone: 573-644-7909 Fax: 573-644-7908 |