| Blue Springs Psychological Services Llc | |
|
1924 Nw Copper Oaks Cir Blue Springs MO 64015-8300 | |
| (816) 224-6500 | |
| (816) 224-2777 |
| Full Name | Blue Springs Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1924 Nw Copper Oaks Cir, Blue Springs, Missouri |
| Authorized Official Name and Position | Jeffrey Leo Miller (OWNER) |
| Authorized Official Contact | 8162246500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Springs Psychological Services Llc 1924 Nw Copper Oaks Cir Blue Springs MO 64015-8300 Ph: (816) 224-6500 | Blue Springs Psychological Services Llc 1924 Nw Copper Oaks Cir Blue Springs MO 64015-8300 Ph: (816) 224-6500 |
| NPI Number | 1376753301 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 11/20/2012 |
| Medicare PECOS PAC ID | 8820221211 |
|---|---|
| Medicare Enrollment ID | O20140509001658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376753301 | NPI | - | NPPES |
| 1700806098 | Other | MO | NPI TYPE 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY00986 (Missouri) | Primary |
| Provider Name | Jeffrey Leo Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700806098 PECOS PAC ID: 0042281487 Enrollment ID: I20040802000385 |
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