ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER NPI 1942449194

NPI Information

NPI: 1942449194
Provider Name: ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
5355 PAGE AVENUE
ST. LOUIS, MO
ZIP 63112
Phone: (314) 531-0120
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ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER is an adolescent and children mental health clinic center in St. Louis, MO. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. ANNIE MALONE CHILDREN AND FAMILY SERVICE CENTER NPI is 1942449194. The provider is registered as an organization entity type.

The provider's business location address is:

5355 PAGE AVENUE
ST. LOUIS, MO
ZIP 63112
Phone: (314) 531-0120
Fax: (314) 531-0125

The provider's authorized official is Channel Genise Thomas .
The authorized official title is Director Of Clinical And Outpatient and has the following contact phone number (314) 565-1110.

The enumeration date for this NPI number is 2/11/2009 and was last updated on 2/5/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			Yes
2	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		002136058	MISSOURI	No
3	385H00000X	Respite Care		001305902	MISSOURI	No
4	251300000X	Local Education Agency (LEA)		SEO200902	MISSOURI	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1942449194	MEDICAID	MISSOURI
2	506278209	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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