| Dr. Melinda Shaver, L.l.c. | |
|
201 N Penn Ave Suite 507 Independence KS 67301-3357 | |
| (620) 926-1286 | |
| Not Available |
| Full Name | Dr. Melinda Shaver, L.l.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 201 N Penn Ave, Independence, Kansas |
| Authorized Official Name and Position | Melinda Anne Shaver (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6209261286 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Melinda Shaver, L.l.c. 201 N Penn Ave Suite 507 Independence KS 67301-3357 Ph: (620) 926-1286 | Dr. Melinda Shaver, L.l.c. 201 N Penn Ave Suite 507 Independence KS 67301-3357 Ph: (620) 926-1286 |
| NPI Number | 1679959811 |
|---|---|
| Provider Enumeration Date | 08/10/2015 |
| Last Update Date | 03/02/2016 |
| Medicare PECOS PAC ID | 0749587319 |
|---|---|
| Medicare Enrollment ID | O20160325000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679959811 | NPI | - | NPPES |
| 201124310A | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2326 (Kansas) | Primary |
| 251S00000X | Community/behavioral Health | 962 (Oklahoma) | Secondary |
| Provider Name | Melinda A Shaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427061209 PECOS PAC ID: 2365402096 Enrollment ID: I20160809002086 |
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