| Good-nous Family Counseling Center, Llc | |
|
2085 S Boston Pl Bolivar MO 65613-2871 | |
| (417) 326-2418 | |
| (417) 326-2419 |
| Full Name | Good-nous Family Counseling Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2085 S Boston Pl, Bolivar, Missouri |
| Authorized Official Name and Position | John Richard Spooner (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4173262418 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good-nous Family Counseling Center, Llc 2085 S Boston Pl Bolivar MO 65613-2871 Ph: (417) 326-2418 | Good-nous Family Counseling Center, Llc 2085 S Boston Pl Bolivar MO 65613-2871 Ph: (417) 326-2418 |
| NPI Number | 1447590104 |
|---|---|
| Provider Enumeration Date | 02/18/2013 |
| Last Update Date | 09/25/2013 |
| Medicare PECOS PAC ID | 6103060058 |
|---|---|
| Medicare Enrollment ID | O20130917000105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447590104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2002023735 (Missouri) | Secondary |
| 103TC0700X | Psychologist - Clinical | 2006034106 (Missouri) | Primary |
| Provider Name | John R Spooner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750351409 PECOS PAC ID: 7719084151 Enrollment ID: I20070521000317 |
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