| Tim Bizelli Counseling Llc | |
|
8759 Veterans Memorial Pkwy O Fallon MO 63366-7538 | |
| (636) 345-1106 | |
| (636) 356-1319 |
| Full Name | Tim Bizelli Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8759 Veterans Memorial Pkwy, O Fallon, Missouri |
| Authorized Official Name and Position | Tim Duane Bizelli (OWNER/CLINICAL SUPERVISOR) |
| Authorized Official Contact | 6363451106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Bizelli Counseling Llc 230 Gobbler Dr Troy MO 63379-2578 Ph: (636) 345-1106 | Tim Bizelli Counseling Llc 8759 Veterans Memorial Pkwy O Fallon MO 63366-7538 Ph: (636) 345-1106 |
| NPI Number | 1659035350 |
|---|---|
| Provider Enumeration Date | 10/28/2021 |
| Last Update Date | 10/28/2021 |
| Certification Date | 10/28/2021 |
| Medicare PECOS PAC ID | 8820535081 |
|---|---|
| Medicare Enrollment ID | O20240806000378 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659035350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Shehnaaz S Danak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538384979 PECOS PAC ID: 3274631536 Enrollment ID: I20070611000052 |
| Provider Name | Katherine Anne Rufle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588948731 PECOS PAC ID: 2567810419 Enrollment ID: I20231202000628 |
| Provider Name | Tim Duane Bizelli |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285807222 PECOS PAC ID: 0749727907 Enrollment ID: I20240806000357 |
| Provider Name | Christopher P Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417229550 PECOS PAC ID: 8527505734 Enrollment ID: I20240806002853 |
| Provider Name | Paul Buford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356041727 PECOS PAC ID: 4587101654 Enrollment ID: I20240807000769 |
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