| Emergence Psychological Services | |
|
1131 Thornwood Dr Saint Louis MO 63124-1227 | |
| (314) 800-4215 | |
| Not Available |
| Full Name | Emergence Psychological Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1131 Thornwood Dr, Saint Louis, Missouri |
| Authorized Official Name and Position | Jameca Woody-cooper (COUNSELING PSYCHOLOGIST) |
| Authorized Official Contact | 3148004215 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emergence Psychological Services 8000 Bonhomme Ave Ste 206 Clayton MO 63105-3515 Ph: (314) 800-4215 | Emergence Psychological Services 1131 Thornwood Dr Saint Louis MO 63124-1227 Ph: (314) 800-4215 |
| NPI Number | 1194140756 |
|---|---|
| Provider Enumeration Date | 02/19/2014 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 9537391693 |
|---|---|
| Medicare Enrollment ID | O20140404000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194140756 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | LC1378481 (Missouri) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jameca Falconer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942242227 PECOS PAC ID: 4981607702 Enrollment ID: I20070206000036 |
| Provider Name | Rosemary B Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790992576 PECOS PAC ID: 7618135518 Enrollment ID: I20120223000541 |
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