ST. LOUIS CENTER FOR COGNITIVE HEALTH, LLC (NPI# 1720576663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720576663 |
Entity Type | Organization |
Organization Name | ST. LOUIS CENTER FOR COGNITIVE HEALTH, LLC |
Practice Address |
7711 Bonhomme Ave Ste 350 Clayton MO 63105 |
Mailing Address |
7711 Bonhomme Ave Ste 350 Clayton MO 63105-1958 |
Practice Telephone | 3148334210 |
Practice Fax Number | 3148334212 |
Mailing Telephone | 3148334210 |
Mailing Fax Number | 3148334212 |
Enumeration Date | 2018-04-26 |
Last Update Date | 2018-11-13 |
Authorized Official Name | DR. ANDREW ROBERTS REILLY MENATTI (DIRECTOR) |
Authorized Official Telephone | 3148334210 |
Authorized Official Credential | PH.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
2017002021 | MO | Ambulatory Health Care Facilities |
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
2017002021 | MO | Ambulatory Health Care Facilities |
Y | 103G00000X | Clinical Neuropsychologist | 2017002021 | MO | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
509 Hamacher St Ste 202, Waterloo, IL 622981592 | 3148334210 | 3148334212 |
Street Address |
7711 BONHOMME AVE STE 350 |
City | CLAYTON |
State | MO |
Zip Code | 63105 |
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 |
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 |
1528325529 | Lin Hao | Internal Medicine | 7571 Wellington Way Apt 2a, Clayton, MO 63105 | 2012-04-13 |
Find all providers in zip 63105 |
Taxonomy Code | 103G00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Clinical Neuropsychologist |
An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275642464 | William Franklin Mcdaniel | Clinical Neuropsychologist | 172 South Main Street, Suite 2, Clayton, GA 30525-4267 | 2006-08-30 |
1982108163 | Andrew Roberts Reilly Menatti | Clinical Neuropsychologist | 7711 Bonhomme Ave, Ste 350, Clayton, MO 63105-1958 | 2018-03-21 |
1841322153 | Herbert Goldman | Clinical Neuropsychologist | 8021 Kingsbury Blvd, Clayton, MO 63105-3715 | 2007-03-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144873159 | Stephanie Ross Potts | Clinical Neuropsychologist | 1027 Bellevue Ave Ste 142, Saint Louis, MO 63117-1851 | 2019-07-18 |
1780127449 | Gateway Neuropsychology, LLC | Clinical Neuropsychologist | 989 Gardenview Office Pkwy, Creve Coeur, MO 63141-5917 | 2016-11-29 |
1508259003 | Maria Catherine Rothhaar | Clinical Neuropsychologist | 522 N New Ballas Rd Ste 121, Saint Louis, MO 63141-6820 | 2015-03-09 |
1578909925 | Sharon Brooks | Clinical Neuropsychologist | 2209 Potomac Dr, Columbia, MO 65203-5886 | 2013-05-13 |
1306190913 | Robert L Coffman | Clinical Neuropsychologist | 1245 N Butterfield Rd Ste C1, Bolivar, MO 65613-3017 | 2012-11-05 |
1366790941 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 175 S. Marshall, Suite G, Rogersville, MO 65742 | 2012-08-29 |
1750612925 | Stress Control Center Inc, P C | Clinical Neuropsychologist | 800 W 47th St Ste 514, Kansas City, MO 64112-1247 | 2010-01-27 |
1366694937 | Dawn Heather Huber | Clinical Neuropsychologist | 175 S Marshall St, Suite G, Rogersville, MO 65742-8828 | 2008-10-15 |
1689852253 | Stacey Woodrome | Clinical Neuropsychologist | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2008-02-06 |
1659551406 | Wright & Wright, Phd, LLC | Clinical Neuropsychologist | 16141 Swingley Ridge Rd, Suite 106, Chesterfield, MO 63017-1774 | 2007-11-09 |
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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.