LAKESIDE BEHAVIORAL HEALTH LLC NPI 1093269003

NPI Information

  • NPI: 1093269003
  • Provider Name: LAKESIDE BEHAVIORAL HEALTH, LLC
  • Classification: Psychiatry & Neurology - 2084P0800X
  • Specialization: Psychiatry
  • Entity Type: Organization
  • Address: 4121 UNION RD
    SUITE 201
    SAINT LOUIS, MO
    ZIP 63129
  • Phone: (314) 930-3520

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NPI Details

LAKESIDE BEHAVIORAL HEALTH, LLC is a psychiatry psychiatry neurology in Saint Louis, MO. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. LAKESIDE BEHAVIORAL HEALTH, LLC NPI is 1093269003. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4121 UNION RD
SUITE 201
SAINT LOUIS, MO
ZIP 63129-070
Phone: (314) 930-3520

The provider's authorized official is Ashok Yanamadala .
The authorized official title is Psychiatrist and has the following contact phone number (314) 930-3520.

The enumeration date for this NPI number is 8/8/2016 and was last updated on 8/19/2019.

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
12084P0800XPsychiatry & NeurologyPsychiatryYes

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
11093269003MEDICAIDMISSOURI
2MA6412OTHERMISSOURIMEDICARE PTAN

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: 11/21/2025

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