DR. ALWYN S. WHITEHEAD JR. (NPI# 1922212604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922212604 |
| Entity Type | Individual |
| Full Name | DR. ALWYN S. WHITEHEAD JR. |
| Other Name | ALWYN S WHITEHEAD |
| Credential | PSY.D. |
| Practice Address |
6920 Bancroft Ave Saint Louis MO 63109-1902 |
| Practice Telephone | 4172341670 |
| Mailing Telephone | 4172341670 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-04-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 2002011127 | MO | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2002011127 | MO | Behavioral Health & Social Service Providers |
| N | 103TF0200X |
Psychologist Specialization: Forensic |
2002011127 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | TAX ID | 43-1804357 | 01 |
| Street Address |
6920 BANCROFT AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63109-1902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431907 | James Edward Trout | Community Health Worker | 3956 Wenzlick Ave, St Louis, MO 63109 | 2017-08-01 |
| 1750815023 | Andrea Hyde | Nurse Practitioner | 5302 Chippewa Street, Suite 301, St Louis, MO 63109 | 2017-04-13 |
| 1215362124 | Alex Sharifian Dds Francis Park Dentistry PC | Dentist | 6650 Chippewa Street, Saint Louis, MO 63109 | 2013-09-10 |
| 1881993962 | Rachel Elizabeth Hale Hasper | Counselor | 6555 Chippewa, St Louis, MO 63109 | 2011-03-15 |
| 1730369885 | Janis Marie Lampa | Physical Therapist | 5203 Chippewa, Suite 301, St. Louis, MO 63109 | 2007-11-06 |
| 1285753772 | James Matthew Jordan | Occupational Therapist | 32 Hampton Village Plaza, St Louis, MO 63109 | 2007-03-28 |
| 1730224478 | Mercy Health Services, LLC | Optometrist | 34 Hampton Village Plaza, St. Louis, MO 63109 | 2007-02-20 |
| 1801959903 | John Thomas Doyle | Dentist | 5400 Walsh St, St Louis, MO 63109 | 2006-12-19 |
| 1649339771 | Residencial Services Corporation | Assisted Living Facility | 5890 Eichelberger, St Louis, MO 63109 | 2006-12-06 |
| 1316039852 | Gary Raymond Rieser | Dentist | 3915 Watson Road, Suite 205, Saint Louis, MO 63109 | 2006-09-29 |
| Find all providers in zip 63109 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174147649 | Melissa Turkel | Psychologist | 915 N Grand Blvd # 116-jc, Saint Louis, MO 63106-1621 | 2020-06-01 |
| 1629600085 | Dr Richard Heise LLC | Psychologist | 10621 Midland Manor Ct, Saint Louis, MO 63114-1202 | 2020-02-04 |
| 1598302226 | Taylor Montgomery | Psychologist | 12837 Flushing Meadows Dr Ste 220, Saint Louis, MO 63131-1824 | 2019-12-02 |
| 1265917884 | Gillian Sloane Mayersohn | Psychologist | 1 Childrens Pl Ste 3n14, Saint Louis, MO 63110-1002 | 2018-09-28 |
| 1265944466 | Brittany Jacobson | Psychologist | 1 Jefferson Barracks Rd # 116b, Saint Louis, MO 63125-4181 | 2017-10-27 |
| 1801316690 | David Howard Morris | Psychologist | 4921 Parkview Pl # 90-35703, Saint Louis, MO 63110-1032 | 2017-06-22 |
| 1144774647 | Carolyn Ashley Myles Versical | Psychologist | 26 Godwin Ln, Saint Louis, MO 63124 | 2016-08-12 |
| 1376980326 | Joshua Paul Beaman-kogan | Psychologist | 1 University Blvd # 232, Stadler Hall, Saint Louis, MO 63121-4400 | 2013-05-31 |
| 1104176064 | Brooke Kraushaar,psy.d,llc | Psychologist | 6321 Alamo Ave, Saint Louis, MO 63105-3103 | 2012-09-18 |
| 1326335837 | Jeremiah Weinstock | Psychologist | 3511 Laclede Ave, Shannon Hall, Room 208, Saint Louis, MO 63103-2010 | 2011-07-05 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63109 |
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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.