Dr Mary Beth Summerville, PHD in Town And Country, MO

Dr Mary Beth Summerville, PHD is a medicare enrolled "Psychologist - Clinical" provider in Town And Country, Missouri. Her current practice location is 425 S Woods Mill Rd Ste 150, Town And Country, Missouri. You can reach out to her office (for appointments etc.) via phone at (636) 939-2550.

Dr Mary Beth Summerville is licensed to practice in Missouri (license number 2018043945) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1508946195.

Contact Information

	Dr Mary Beth Summerville, PHD
	425 S Woods Mill Rd Ste 150, Town And Country, MO 63017-9528
	(636) 939-2550
	(314) 627-4978

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Mary Beth Summerville
Gender	Female
Speciality	Psychologist - Clinical
Location	425 S Woods Mill Rd Ste 150, Town And Country, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1508946195
Provider Enumeration Date: 10/17/2006
Last Update Date: 01/29/2026

Medicare PECOS Information:

PECOS PAC ID: 4981625837
Enrollment ID: I20220104000308

Medical Identifiers

Medical identifiers for Dr Mary Beth Summerville such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1508946195	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	2018043945 (Missouri)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mary Beth Summerville allows following entities to bill medicare on her behalf.

Entity Name	Affinia Healthcare
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902816077 PECOS PAC ID: 1052386919 Enrollment ID: O20040902000048

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary Beth Summerville is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Mary Beth Summerville, PHD 425 S Woods Mill Rd Ste 150, Town And Country, MO 63017-9528 Ph: (636) 939-2550	Dr Mary Beth Summerville, PHD 425 S Woods Mill Rd Ste 150, Town And Country, MO 63017-9528 Ph: (636) 939-2550

Reviews and Comments

Psychologist in Town And Country, MO

Dr. Lisa Marie Sinden-gottfried, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 14377 Woodlake Dr Ste 315, Town And Country, MO 63017 Phone: 314-304-3707
Dr. Audrey Stutsman, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 425 S Woods Mill Rd Ste 150, Town And Country, MO 63017 Phone: 314-269-0335
Brian Richter, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 13001 N Outer 40 Rd # 2b, Town And Country, MO 63017 Phone: 314-454-6069 Fax: 314-726-6069
Sharon Moehle, ED,S. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 266 Lamp And Lantern Vlg, Town And Country, MO 63017 Phone: 636-227-4949 Fax: 636-779-1456
Monica Marie Rojas, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 13001 North Outer 40 Rd, Town And Country, MO 63017 Phone: 314-454-6069
Dr. Michael G.s. Gottfried, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 14377 Woodlake Dr Ste 315, Town And Country, MO 63017 Phone: 314-304-3707

Dr Mary Beth Summerville, PHD - Medicare Psychologist in Town And Country, MO