| Gateway Counseling Center, Inc. | |
|
1864 S Kentwood Ave Springfield MO 65804-2323 | |
| (417) 869-8400 | |
| (417) 869-8401 |
| Full Name | Gateway Counseling Center, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1864 S Kentwood Ave, Springfield, Missouri |
| Authorized Official Name and Position | Ernest Grant Jones (PRESIDENT) |
| Authorized Official Contact | 4178698400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Counseling Center, Inc. 1864 S Kentwood Ave Springfield MO 65804-2323 Ph: (417) 869-8400 | Gateway Counseling Center, Inc. 1864 S Kentwood Ave Springfield MO 65804-2323 Ph: (417) 869-8400 |
| NPI Number | 1962632489 |
|---|---|
| Provider Enumeration Date | 07/17/2009 |
| Last Update Date | 12/04/2018 |
| Medicare PECOS PAC ID | 9234282112 |
|---|---|
| Medicare Enrollment ID | O20090727000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962632489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Melody Darlene Palm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053528505 PECOS PAC ID: 9436225737 Enrollment ID: I20080911000115 |
| Provider Name | Ernest Grant Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831370592 PECOS PAC ID: 2163575044 Enrollment ID: I20090727000115 |
| Provider Name | Jacey Lauren Collins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518562701 PECOS PAC ID: 4880043421 Enrollment ID: I20231208000514 |
| Provider Name | Elizabeth M Dardenne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336698059 PECOS PAC ID: 7315396975 Enrollment ID: I20231208000872 |
| Provider Name | Nathen David Ransom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952754228 PECOS PAC ID: 5496104697 Enrollment ID: I20231215001411 |
| Provider Name | Sue Ann Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144356155 PECOS PAC ID: 4880044825 Enrollment ID: I20240103001262 |
| Provider Name | Stephen Frederick Meamber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326418047 PECOS PAC ID: 8224489232 Enrollment ID: I20240103004152 |
| Provider Name | Magda W Romman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972772549 PECOS PAC ID: 8325499940 Enrollment ID: I20240109000238 |
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