PHOENIX PSYCHOLOGICAL GROUP, INC (NPI# 1386767994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386767994 |
| Entity Type | Organization |
| Organization Name | PHOENIX PSYCHOLOGICAL GROUP, INC |
| Practice Address |
225 S Meramec Ave Suite 506 Saint Louis MO 63105-3596 |
| Practice Telephone | 3148633588 |
| Practice Fax Number | 3148630074 |
| Mailing Telephone | 3148633588 |
| Mailing Fax Number | 3148630074 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. PATRICIA S SHAW (PRESIDENT) |
| Authorized Official Telephone | 3148633588 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
PY01201 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 493257802 | 05 | |
| MO | NPI-PATRICIA SHAW | 1245254317 | 01 |
| Street Address |
225 S MERAMEC AVE SUITE 506 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63105-3596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043208499 | Linda Marie Guhe | Social Worker | 225 S Meramec Ave, Suite 205, Saint Louis, MO 63105-3511 | 2005-10-10 |
| 1063950657 | Ultimate Health LLC | Chiropractor | 225 S Meramec Ave, Ste. 306, Saint Louis, MO 63105-3511 | 2017-02-03 |
| 1952763286 | Amanda Peiffer | Chiropractor | 225 S Meramec Ave, #306, Saint Louis, MO 63105-3511 | 2016-03-25 |
| 1891187233 | Delia L Hobbins Dc, LLC | Chiropractor | 225 S Meramec Ave, Suite 306, Saint Louis, MO 63105-3511 | 2015-02-23 |
| 1285024893 | Delia L Overschmidt | Chiropractor | 225 S Meramec Ave, Suite 306, Saint Louis, MO 63105-3511 | 2015-02-03 |
| 1609151331 | Linda Wheatland Smith, D.c., P.C. | Chiropractor | 225 S Meramec Ave, Suite 306, Saint Louis, MO 63105-3511 | 2011-10-13 |
| 1154606044 | Catherine Hoyt Drazen | Occupational Therapist | 225 S Meramec Ave, Suite 1033t, Saint Louis, MO 63105-3511 | 2011-10-11 |
| 1568699809 | Alyssa Person | Social Worker | 225 S Meramec Ave, 1029t, Saint Louis, MO 63105-3511 | 2009-06-13 |
| 1285874040 | Jason Selk | Counselor | 225 S Meramec Ave, Suite 829, Saint Louis, MO 63105-3511 | 2009-03-05 |
| 1700026952 | Sundeepjayaprabhu Md LLC | Psychiatry & Neurology | 225 S Meramec Ave, Suite #932t, Saint Louis, MO 63105-3511 | 2009-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016545 | Amy Piontek | Registered Nurse | Habif Health and Wellness Center, 6643 Shepley Drive, St. Louis, MO 63105 | 2020-05-29 |
| 1427520634 | Justin Kelly | Chiropractor | 8011 Maryland Avenue, St. Louis, MO 63105 | 2018-12-28 |
| 1720576663 | St. Louis Center for Cognitive Health, LLC | Clinic/Center | 7711 Bonhomme Ave Ste 350, Clayton, MO 63105 | 2018-04-26 |
| 1457849317 | A Storied Life Counseling LLC | Social Worker | 8000 Bonhomme Ave Ste 321, Clayton, MO 63105 | 2018-04-26 |
| 1669984142 | Peter Bogart | Counselor | 7710 Carondelet, Suite #204, Saint Louis, MO 63105 | 2017-10-24 |
| 1356891162 | Medical West Respiratory Pharmacy, LLC | Pharmacy | 440 South Brentwood Blvd, Clayton, MO 63105 | 2016-10-05 |
| 1710435565 | James Breihan | Occupational Therapist | 401 Corporate Park Drive, Clayton, MO 63105 | 2016-09-21 |
| 1730566928 | Frank Theus | Counselor | 7710 Carondelet Ave Ste 220, Saint Louis, MO 63105 | 2015-04-27 |
| 1962895896 | John B Martin | Obstetrics & Gynecology | 312 N. Meramec #300, St. Louis, MO 63105 | 2015-03-17 |
| 1861814261 | Jesse Marie Civello | Physical Therapist | 222 S Meramec Avenue, Suite 100, Clayton, MO 63105 | 2014-01-20 |
| Find all providers in zip 63105 | ||||
| Taxonomy Code | 103TP0016X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Prescribing (Medical) |
| Those licensed psychologists who have completed specialized, post-doctoral training in psychopharmacology, passed a national proficiency examination in psychopharmacology, and who are authorized by state statute to prescribe medications, in accordance with their state law and state licensing authority, for the evaluation, diagnosis, management and treatment of mental, nervous, emotional, behavioral, and related disorders. |
| Notes: Source: Louisiana Academy of Medical Psychologists Note: Some states issue licenses under Medical Psychologist. [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114253549 | Lynn Ashley Cunningham | Psychologist | 8 W Pine Ct, Saint Louis, MO 63108-2110 | 2009-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972167773 | Great Plains Hospital | Psychologist | 1500 W Ashland St, Nevada, MO 64772-1710 | 2019-04-26 |
| 1902244825 | Gateway Psychiatric Group, LLC | Psychologist | 11710 Old Ballas Rd, Suite 110, Creve Coeur, MO 63141-7076 | 2013-06-13 |
| 1972859510 | Forest Park Neurology LLC | Psychologist | 5811 E Truman Rd, Kansas City, MO 64126-2400 | 2012-08-01 |
| 1376757617 | M A Mirza, LLC | Psychologist | 4045 Ne Lakewood Way, Suite 130, Lees Summit, MO 64064-1799 | 2007-05-09 |
| City | SAINT LOUIS |
| Zip Code | 63105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.