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SPRINGFIELD PSYCHIATRY & ADDICTION MEDICINE LLC NPI 1427733898


NPI Information

NPI: 1427733898
Provider Name: SPRINGFIELD PSYCHIATRY & ADDICTION MEDICINE LLC
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 26D2285850

Address:
3646 S CAMPBELL AVE
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 557-2355
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SPRINGFIELD PSYCHIATRY & ADDICTION MEDICINE LLC is an addiction medicine psychiatry neurology in Springfield, MO. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine SPRINGFIELD PSYCHIATRY & ADDICTION MEDICINE LLC NPI is 1427733898. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3646 S CAMPBELL AVE
SPRINGFIELD, MO
ZIP 65807-202
Phone: (417) 557-2355

The provider's authorized official is Michelle Raymond .
The authorized official title is Clinic Director and has the following contact phone number (417) 343-2577.

The CLIA number assigned to this NPI record is 26D2285850 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2023 and was last updated on 8/25/2023.


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
12084A0401XPsychiatry & NeurologyAddiction MedicineYes

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

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