COMMUNITY & LONG-TERM CARE PSYCHIATRY LLC (NPI# 1528415536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528415536 |
| Entity Type | Organization |
| Organization Name | COMMUNITY & LONG-TERM CARE PSYCHIATRY LLC |
| Practice Address |
10004 Kennerly Rd Ste 362b Saint Louis MO 63128-2141 |
| Practice Telephone | 3148490450 |
| Practice Fax Number | 3148490159 |
| Mailing Telephone | 3148490450 |
| Mailing Fax Number | 3148490159 |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |
| Authorized Official Name | MRS. BETTY JANE DICKERMAN (BILLING MANAGER) |
| Authorized Official Telephone | 3148490450 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 2015002634 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1265723407 | 05 |
| Street Address |
10004 KENNERLY RD STE 362B |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053317313 | Sylvia Ann Steiling | Surgery | 10004 Kennerly Rd, Ste 137a, Saint Louis, MO 63128-2140 | 2005-06-22 |
| 1376166066 | Nhs South LLC | Internal Medicine | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2020-05-28 |
| 1932690567 | Kristin Leigh Wall | Registered Nurse | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2018-05-18 |
| 1447795695 | Laura Michler | Nurse Practitioner | 10004 Kennerly Rd, Ste 115a, Saint Louis, MO 63128-2141 | 2016-12-27 |
| 1346796562 | Jennifer Lynn Seib | Nurse Practitioner | 10004 Kennerly Rd, Ste. 255a, Saint Louis, MO 63128-2141 | 2016-08-28 |
| 1083081004 | Frank H Gafford Md, PC | Internal Medicine | 10004 Kennerly Rd, Suite 283b, Saint Louis, MO 63128-2141 | 2015-08-25 |
| 1710375340 | Sabina Smajis | Nurse Practitioner | 10004 Kennerly Rd, Saint Louis, MO 63128-2141 | 2015-01-05 |
| 1962810952 | St. Anthony's Physician Organization | Internal Medicine | 10004 Kennerly Rd, Suite 200a, Saint Louis, MO 63128-2141 | 2014-07-23 |
| 1457766255 | St. Anthony's Physician Organization | Obstetrics & Gynecology | 10004 Kennerly Rd, Ste 395b, Saint Louis, MO 63128-2141 | 2014-07-01 |
| 1811319320 | St. Anthony's Physician Organization | Audiologist | 10004 Kennerly Rd, Suite 205a, Saint Louis, MO 63128-2141 | 2014-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828906 | Davis Nicole Norber | Behavioral Analyst | 2 Stacy Dr, Saint Louis, MO 63132-4120 | 2020-10-14 |
| 1598375065 | Heather Ann Kulash | Behavioral Analyst | 3207 Halliday Ave Apt 2e, Saint Louis, MO 63118-1264 | 2020-08-08 |
| 1972135606 | Emergent Learning, LLC | Behavioral Analyst | 2055 Craigshire Rd Ste 390, Saint Louis, MO 63146-4028 | 2020-02-11 |
| 1184268963 | Zenia Ann Roberts | Behavioral Analyst | 1694 S Mason Rd, Saint Louis, MO 63131-1215 | 2019-11-04 |
| 1184272072 | Arkila 360 Degrees Counseling and Consulting Services | Behavioral Analyst | 1400 Russell Blvd, Saint Louis, MO 63104-4384 | 2019-09-03 |
| 1164982054 | Anna Hastings | Behavioral Analyst | 5356 Vernon Ave, Saint Louis, MO 63112-3312 | 2019-03-25 |
| 1659835056 | Antonia Raye Stillpass | Behavioral Analyst | 7522 Big Bend Blvd, Saint Louis, MO 63119-2104 | 2019-01-30 |
| 1316417785 | Shiquita Lynne Lane | Behavioral Analyst | 520 Elizabeth Dr, Saint Louis, MO 63119-4240 | 2018-11-28 |
| 1215459722 | Matthew Page | Behavioral Analyst | 4000 Healy Ct, Saint Louis, MO 63123-7743 | 2017-07-17 |
| 1295261048 | Establishing Interactions | Behavioral Analyst | 6190 Washington Blvd, Saint Louis, MO 63112-1208 | 2017-05-11 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.