PHOENIX PSYCHOLOGICAL GROUP INC NPI 1386767994

NPI Information

  • NPI: 1386767994
  • Provider Name: PHOENIX PSYCHOLOGICAL GROUP, INC
  • Classification: Psychologist - 103TP0016X
  • Specialization: Prescribing (Medical)
  • Entity Type: Organization
  • Address: 225 S MERAMEC AVE
    SUITE 506
    SAINT LOUIS, MO
    ZIP 63105
  • Phone: (314) 863-3588

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NPI Details

PHOENIX PSYCHOLOGICAL GROUP, INC is a prescribing (medical) psychologist in Saint Louis, MO. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. PHOENIX PSYCHOLOGICAL GROUP, INC NPI is 1386767994. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

225 S MERAMEC AVE
SUITE 506
SAINT LOUIS, MO
ZIP 63105-596
Phone: (314) 863-3588
Fax: (314) 863-0074

The provider's authorized official is Patricia S Shaw .
The authorized official title is President and has the following contact phone number (314) 863-3588.

The enumeration date for this NPI number is 4/9/2007 and was last updated on 8/22/2020.

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
1103TP0016XPsychologistPrescribing (Medical)PY01201MISSOURIYes

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
1493257802MEDICAIDMISSOURI
21245254317OTHERMISSOURINPI-PATRICIA SHAW

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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