| Community Reach | |
|
3751 Pennridge Dr Ste 119 Bridgeton MO 63044-1244 | |
| (314) 443-7776 | |
| Not Available |
| Full Name | Community Reach |
|---|---|
| Speciality | Clinic/Center |
| Location | 3751 Pennridge Dr Ste 119, Bridgeton, Missouri |
| Authorized Official Name and Position | Ebony Hutchinson (OWNER) |
| Authorized Official Contact | 3144497776 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Reach 3751 Pennridge Dr Ste 119 Bridgeton MO 63044-1244 Ph: (314) 443-7776 | Community Reach 3751 Pennridge Dr Ste 119 Bridgeton MO 63044-1244 Ph: (314) 443-7776 |
| NPI Number | 1952901688 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 12/07/2020 |
| Certification Date | 12/07/2020 |
| Medicare PECOS PAC ID | 7911311741 |
|---|---|
| Medicare Enrollment ID | O20210205001276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952901688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | April D Lomax |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871884312 PECOS PAC ID: 2567610827 Enrollment ID: I20120912000470 |
| Provider Name | Marisha Lachelle Griffin-essex |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902243587 PECOS PAC ID: 1951641612 Enrollment ID: I20190318000628 |
| Provider Name | Ebony Cheri Hutchinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033253208 PECOS PAC ID: 0648684472 Enrollment ID: I20210205001430 |
| Provider Name | Desley Diane Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477877520 PECOS PAC ID: 6406208172 Enrollment ID: I20240118000581 |
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