| St. Louis Behavioral Health Services, Llc | |
|
12255 Depaul Dr Suite 490 Bridgeton MO 63044 | |
| (314) 344-7770 | |
| (314) 298-0556 |
| Full Name | St. Louis Behavioral Health Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12255 Depaul Dr, Bridgeton, Missouri |
| Authorized Official Name and Position | M Javed Qasim (CEO) |
| Authorized Official Contact | 3143447770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Louis Behavioral Health Services, Llc 12255 Depaul Dr Suite 490 Bridgeton MO 63044 Ph: (314) 344-7770 | St. Louis Behavioral Health Services, Llc 12255 Depaul Dr Suite 490 Bridgeton MO 63044 Ph: (314) 344-7770 |
| NPI Number | 1487994877 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 03/06/2017 |
| Medicare PECOS PAC ID | 9830336288 |
|---|---|
| Medicare Enrollment ID | O20130502000522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487994877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | R3N44 (Missouri) | Primary |
| Provider Name | Fradi Spilberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184623787 PECOS PAC ID: 2062429384 Enrollment ID: I20060313000039 |
| Provider Name | Amy Marty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982880548 PECOS PAC ID: 3476622374 Enrollment ID: I20080519000387 |
| Provider Name | M. Javed Qasim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578562310 PECOS PAC ID: 1254412844 Enrollment ID: I20100928001141 |
| Provider Name | Ebele N Iloabachie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093050841 PECOS PAC ID: 7113172883 Enrollment ID: I20130301000458 |
| Provider Name | Barbara Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083864268 PECOS PAC ID: 1759503279 Enrollment ID: I20141117000491 |
| Provider Name | Saima Baig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033619044 PECOS PAC ID: 8325300882 Enrollment ID: I20180320003500 |
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