| Imynd Connects, Llc | |
|
745 Craig Rd Ste 104 Creve Coeur MO 63141-7122 | |
| (314) 606-1265 | |
| Not Available |
| Full Name | Imynd Connects, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 745 Craig Rd Ste 104, Creve Coeur, Missouri |
| Authorized Official Name and Position | Susan Elizabeth Stevenson Moore (OWNER) |
| Authorized Official Contact | 3146061265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imynd Connects, Llc 745 Craig Rd Ste 104 Creve Coeur MO 63141-7122 Ph: (314) 606-1265 | Imynd Connects, Llc 745 Craig Rd Ste 104 Creve Coeur MO 63141-7122 Ph: (314) 606-1265 |
| NPI Number | 1104446194 |
|---|---|
| Provider Enumeration Date | 04/20/2020 |
| Last Update Date | 05/11/2020 |
| Certification Date | 05/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104446194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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