| Anne B Summers, Llc | |
|
1310 E. Kingsley St., Ste C Springfield MO 65804 | |
| (417) 894-3992 | |
| (417) 332-8680 |
| Full Name | Anne B Summers, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1310 E. Kingsley St., Ste C, Springfield, Missouri |
| Authorized Official Name and Position | Anne Bredeman Summers (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4178943992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anne B Summers, Llc 2110 W. Melbourne Ct. Springfield MO 65810 Ph: (417) 894-3992 | Anne B Summers, Llc 1310 E. Kingsley St., Ste C Springfield MO 65804 Ph: (417) 894-3992 |
| NPI Number | 1306498779 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 07/15/2019 |
| Medicare PECOS PAC ID | 5496182099 |
|---|---|
| Medicare Enrollment ID | O20200220001144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306498779 | NPI | - | NPPES |
| 1205160256 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Anne B Summers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205160256 PECOS PAC ID: 0648441600 Enrollment ID: I20110922000611 |
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