| Cherie Baetz-davis, Ph.d., Llc | |
|
331 N New Ballas Rd Unit 410062 Saint Louis MO 63141-0062 | |
| (314) 804-3624 | |
| (314) 804-5336 |
| Full Name | Cherie Baetz-davis, Ph.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 331 N New Ballas Rd Unit 410062, Saint Louis, Missouri |
| Authorized Official Name and Position | Cherie Baetz-davis (PSYCHOLOGIST) |
| Authorized Official Contact | 3148043624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cherie Baetz-davis, Ph.d., Llc 211 Carrollton Ln Saint Louis MO 63135-1225 Ph: (314) 804-3624 | Cherie Baetz-davis, Ph.d., Llc 331 N New Ballas Rd Unit 410062 Saint Louis MO 63141-0062 Ph: (314) 804-3624 |
| NPI Number | 1821342445 |
|---|---|
| Provider Enumeration Date | 11/05/2012 |
| Last Update Date | 03/22/2024 |
| Certification Date | 03/22/2024 |
| Medicare PECOS PAC ID | 5890946313 |
|---|---|
| Medicare Enrollment ID | O20121109000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821342445 | NPI | - | NPPES |
| 496975814 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 01638 (Missouri) | Primary |
| Provider Name | Cherie A Baetz-davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366437196 PECOS PAC ID: 2163472515 Enrollment ID: I20050125000092 |
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