| Fitzgibbons Psychological West County Psychological Associates | |
|
12125 Woodcrest Executive Dr Saint Louis MO 63141-5001 | |
| (314) 275-8599 | |
| Not Available |
| Full Name | Fitzgibbons Psychological West County Psychological Associates |
|---|---|
| Speciality | Psychologist |
| Location | 12125 Woodcrest Executive Dr, Saint Louis, Missouri |
| Authorized Official Name and Position | Mary Fitzgibbons (DIRECTOR) |
| Authorized Official Contact | 3142758599 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fitzgibbons Psychological West County Psychological Associates 12125 Woodcrest Executive Dr Saint Louis MO 63141-5001 Ph: (314) 275-8599 | Fitzgibbons Psychological West County Psychological Associates 12125 Woodcrest Executive Dr Saint Louis MO 63141-5001 Ph: (314) 275-8599 |
| NPI Number | 1861792723 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 04/14/2015 |
| Medicare PECOS PAC ID | 9537353503 |
|---|---|
| Medicare Enrollment ID | O20101103000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861792723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 00944 (Missouri) | Primary |
| Provider Name | William H Kuntz |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1336122704 PECOS PAC ID: 8628151610 Enrollment ID: I20080214000162 |
| Provider Name | Mary C Fitzgibbons |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679752562 PECOS PAC ID: 1951595925 Enrollment ID: I20101103001006 |
| Provider Name | Lisa M Brazil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457613382 PECOS PAC ID: 1658529466 Enrollment ID: I20120920000487 |
| Provider Name | Jennifer W Vanluven |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619304250 PECOS PAC ID: 1052549110 Enrollment ID: I20140116001830 |
| Provider Name | Amy Kelly Neu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033531207 PECOS PAC ID: 5294966263 Enrollment ID: I20140317001040 |
| Provider Name | Murisa Begic-gusic |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184962623 PECOS PAC ID: 2365663606 Enrollment ID: I20141029002400 |
| Provider Name | Cari L Mcknight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750773594 PECOS PAC ID: 5597082776 Enrollment ID: I20150327000722 |
| Provider Name | Bryan C Duckham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063804821 PECOS PAC ID: 1658698618 Enrollment ID: I20150331002898 |
| Provider Name | Kristen L Carothers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316334311 PECOS PAC ID: 7719206044 Enrollment ID: I20150507001019 |
| Provider Name | Angela C Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255409140 PECOS PAC ID: 9830404284 Enrollment ID: I20150814013184 |
| Provider Name | Marilyn L Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679747364 PECOS PAC ID: 9931415049 Enrollment ID: I20150904000294 |
| Provider Name | Christina M Bardle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255803961 PECOS PAC ID: 1456697366 Enrollment ID: I20190115000926 |
| Provider Name | Chloe P Schechter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497389837 PECOS PAC ID: 8527498328 Enrollment ID: I20200418000552 |
| Provider Name | Katelyn M Schaefer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154931640 PECOS PAC ID: 3678992450 Enrollment ID: I20200928002541 |
| Provider Name | Lori B Goldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982749784 PECOS PAC ID: 2365841251 Enrollment ID: I20210526000577 |
| Provider Name | Mollie P Appelbaum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023761343 PECOS PAC ID: 4981097425 Enrollment ID: I20220207000721 |
| Provider Name | Georgean Rustemeyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629788187 PECOS PAC ID: 2668841750 Enrollment ID: I20221212002976 |
| Provider Name | Theresa F Wiss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780369405 PECOS PAC ID: 6901265198 Enrollment ID: I20230706001908 |
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