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CULTIVATE PSYCHOLOGICAL SERVICES LLC NPI 1396004990


NPI Information

NPI: 1396004990
Provider Name: CULTIVATE PSYCHOLOGICAL SERVICES LLC
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
1439 S ROGERS AVE
SPRINGFIELD, MO
ZIP 65804
Phone: (417) 619-9818
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CULTIVATE PSYCHOLOGICAL SERVICES LLC is a clinical psychologist in Springfield, MO. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. CULTIVATE PSYCHOLOGICAL SERVICES LLC NPI is 1396004990. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1439 S ROGERS AVE
SPRINGFIELD, MO
ZIP 65804-129
Phone: (417) 619-9818

The provider's authorized official is Shelly Jean Farnan .
The authorized official title is Licensed Psychologist/owner/member and has the following contact phone number (417) 619-9818.

The enumeration date for this NPI number is 5/16/2012 and was last updated on 5/16/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical2009030819MISSOURIYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MA1019011OTHERMEDICARE I.D. NUMBER
21962737734MEDICAIDMISSOURI

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.