| Bjc Behavioral Health | |
|
3309 S Kingshighway Blvd Saint Louis MO 63139-1101 | |
| (314) 206-3700 | |
| (314) 206-3881 |
| Full Name | Bjc Behavioral Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 3309 S Kingshighway Blvd, Saint Louis, Missouri |
| Authorized Official Name and Position | Angela Martin-davis (PRESIDENT) |
| Authorized Official Contact | 3142063712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bjc Behavioral Health 3309 S Kingshighway Blvd Saint Louis MO 63139-1101 Ph: (314) 206-3700 | Bjc Behavioral Health 3309 S Kingshighway Blvd Saint Louis MO 63139-1101 Ph: (314) 206-3700 |
| NPI Number | 1669485868 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Medicare PECOS PAC ID | 1153225271 |
|---|---|
| Medicare Enrollment ID | O20031120000936 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669485868 | NPI | - | NPPES |
| 152758215 | Medicaid | MO | |
| 7107625 | Other | MO DEPT OF MENTAL HEALTH | |
| 603805607 | Medicaid | MO | |
| 876175712 | Medicaid | MO | |
| 876175704 | Medicaid | MO | |
| 152758207 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 267-7258 (Missouri) | Primary |
| Provider Name | Eileen Ai-ling Wu-evans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881741825 PECOS PAC ID: 2668360827 Enrollment ID: I20040309000535 |
| Provider Name | Li Shiun Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386658003 PECOS PAC ID: 2860452794 Enrollment ID: I20041015000011 |
| Provider Name | Muhammad Baber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497769194 PECOS PAC ID: 3476518200 Enrollment ID: I20041122000346 |
| Provider Name | Theresa J Villaflores |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609923689 PECOS PAC ID: 7517916653 Enrollment ID: I20050117000013 |
| Provider Name | Robert Brady |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003820184 PECOS PAC ID: 5092764514 Enrollment ID: I20050121000293 |
| Provider Name | John A Coons |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225185283 PECOS PAC ID: 7214963586 Enrollment ID: I20050711000020 |
| Provider Name | Denise Troy Curry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891786406 PECOS PAC ID: 2567538325 Enrollment ID: I20080903000253 |
| Provider Name | Christina A Rariden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881854354 PECOS PAC ID: 1254490568 Enrollment ID: I20081031000203 |
| Provider Name | Gautam Rohatgi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710065024 PECOS PAC ID: 3971667957 Enrollment ID: I20090206000034 |
| Provider Name | Donald D Bohnenkamp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316139116 PECOS PAC ID: 4082892740 Enrollment ID: I20110628000326 |
| Provider Name | Akinkunle Owoso |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063610319 PECOS PAC ID: 7012186281 Enrollment ID: I20110803000805 |
| Provider Name | Mark S Corman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942332267 PECOS PAC ID: 5294803029 Enrollment ID: I20120117000097 |
| Provider Name | Christina G Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427217116 PECOS PAC ID: 7618044231 Enrollment ID: I20120124000896 |
| Provider Name | Subhash Bashyal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811126337 PECOS PAC ID: 9537393004 Enrollment ID: I20131016001436 |
| Provider Name | Paul E Glaser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316020738 PECOS PAC ID: 9133207186 Enrollment ID: I20150505002707 |
| Provider Name | Yasmin Dara Jilla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386804870 PECOS PAC ID: 2163579376 Enrollment ID: I20150507002682 |
| Provider Name | Laura A Shapiro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750395323 PECOS PAC ID: 5799086708 Enrollment ID: I20151216002589 |
| Provider Name | Eric N Wittrock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619265865 PECOS PAC ID: 2264660174 Enrollment ID: I20160607001317 |
| Provider Name | Colleen Elsbeth Donovan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093079352 PECOS PAC ID: 0345479093 Enrollment ID: I20160711001602 |
| Provider Name | Tianyuan Yin Cornell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942644349 PECOS PAC ID: 0042526204 Enrollment ID: I20171128000735 |
| Provider Name | Kelly E Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447273933 PECOS PAC ID: 9234102856 Enrollment ID: I20180719003033 |
| Provider Name | Kristen M Kellerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700340205 PECOS PAC ID: 1557601234 Enrollment ID: I20190315000512 |
| Provider Name | Amy L Salzer Bothmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376787192 PECOS PAC ID: 3870835010 Enrollment ID: I20190508002071 |
| Provider Name | Celsius-kit Gesmundo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558654053 PECOS PAC ID: 0941513626 Enrollment ID: I20190517000634 |
| Provider Name | Kristen D Beatty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598325086 PECOS PAC ID: 4789919408 Enrollment ID: I20190717001137 |
| Provider Name | Keith E Decker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063979011 PECOS PAC ID: 3678907110 Enrollment ID: I20191216003101 |
| Provider Name | Mildred E Fortune-gilpin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013930403 PECOS PAC ID: 7517396302 Enrollment ID: I20200330002492 |
| Provider Name | Swati Sood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801247184 PECOS PAC ID: 0446547087 Enrollment ID: I20200626000408 |
| Provider Name | Brian Hd Bui |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699152249 PECOS PAC ID: 9537475637 Enrollment ID: I20200721002445 |
| Provider Name | Brandon K Akers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285085308 PECOS PAC ID: 3779817655 Enrollment ID: I20200819000133 |
| Provider Name | Oliver J Yost |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629160478 PECOS PAC ID: 8628170743 Enrollment ID: I20211109001493 |
| Provider Name | Nancy Gale Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285301721 PECOS PAC ID: 1052717667 Enrollment ID: I20220802000927 |
| Provider Name | Salat Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396473294 PECOS PAC ID: 3274905732 Enrollment ID: I20230209000214 |
| Provider Name | Stephanie D Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104572262 PECOS PAC ID: 6800261520 Enrollment ID: I20230412000490 |
| Provider Name | Andria M Silver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003562158 PECOS PAC ID: 5799150421 Enrollment ID: I20230412000680 |
| Provider Name | Darin Chia Fay Quach |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679068761 PECOS PAC ID: 9931566692 Enrollment ID: I20230612001380 |
| Provider Name | Anatoliy Kuznetsov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265937080 PECOS PAC ID: 9234524703 Enrollment ID: I20230612001643 |
| Provider Name | Ronit L Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568679579 PECOS PAC ID: 4385779776 Enrollment ID: I20230707000439 |
| Provider Name | Danita T Flakes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083159594 PECOS PAC ID: 0143680405 Enrollment ID: I20230718002422 |
| Provider Name | Shannon R Mcguire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134780471 PECOS PAC ID: 3274869284 Enrollment ID: I20230906001390 |
| Provider Name | Lewis Li Tian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942769856 PECOS PAC ID: 1456686203 Enrollment ID: I20230913000760 |
| Provider Name | Molly K Novak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700892403 PECOS PAC ID: 9739533530 Enrollment ID: I20230927003927 |
| Provider Name | Sofia Y Daneshyar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306509492 PECOS PAC ID: 2062863046 Enrollment ID: I20240104001472 |
| Provider Name | Emily A Slat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942795026 PECOS PAC ID: 8325499304 Enrollment ID: I20240104001481 |
| Provider Name | James Keeton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730565086 PECOS PAC ID: 6305297284 Enrollment ID: I20240104001998 |
| Provider Name | Amy R Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861840134 PECOS PAC ID: 0446601330 Enrollment ID: I20240104002209 |
| Provider Name | Stephanie Weatherspoon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073046850 PECOS PAC ID: 2365886769 Enrollment ID: I20240213003862 |
| Provider Name | Allison L Hewitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750757753 PECOS PAC ID: 7911341771 Enrollment ID: I20240220002490 |
| Provider Name | Leslie D Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477080539 PECOS PAC ID: 9830533603 Enrollment ID: I20240220002887 |
| Provider Name | Jacilynn Tucker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487187845 PECOS PAC ID: 1355786674 Enrollment ID: I20240227001037 |
| Provider Name | Brenda M Brady |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073557989 PECOS PAC ID: 0547154478 Enrollment ID: I20240229003354 |
| Provider Name | Jessica L Wells |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083996037 PECOS PAC ID: 9830534494 Enrollment ID: I20240305002699 |
| Provider Name | Sarah N Bauer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063429405 PECOS PAC ID: 8527404318 Enrollment ID: I20240315000427 |
| Provider Name | Lauren E Gillard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508545039 PECOS PAC ID: 2961840251 Enrollment ID: I20240405000746 |
| Provider Name | Sarah A Bell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154477149 PECOS PAC ID: 8729427919 Enrollment ID: I20240422000334 |
| Provider Name | Amanda Logan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710765540 PECOS PAC ID: 9537508601 Enrollment ID: I20240423000364 |
| Provider Name | Carmelita D West |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619516390 PECOS PAC ID: 4183064975 Enrollment ID: I20240426001124 |
| Provider Name | Patrick Allen Wheeler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932872272 PECOS PAC ID: 7214377035 Enrollment ID: I20240426002171 |
| Provider Name | Janice C Duncan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093911448 PECOS PAC ID: 1850733643 Enrollment ID: I20240524001158 |
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