Bolivar Family Counseling Center Llc | |
5438 S 244th Rd Buffalo MO 65622-9373 | |
(417) 399-4828 | |
Not Available |
Full Name | Bolivar Family Counseling Center Llc |
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Speciality | Psychologist |
Location | 5438 S 244th Rd, Buffalo, Missouri |
Authorized Official Name and Position | Don Axsom (PSYCHOLOGIST/OWNER) |
Authorized Official Contact | 4173994828 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bolivar Family Counseling Center Llc 5438 S 244th Rd Buffalo MO 65622-9373 Ph: (417) 399-4828 | Bolivar Family Counseling Center Llc 5438 S 244th Rd Buffalo MO 65622-9373 Ph: (417) 399-4828 |
NPI Number | 1982895595 |
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Provider Enumeration Date | 08/08/2007 |
Last Update Date | 05/17/2011 |
Identifier | Type | State | Issuer |
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1982895595 | NPI | - | NPPES |
507418903 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | 2003032059 (Missouri) | Secondary |
103T00000X | Psychologist | 2006006562 (Missouri) | Primary |