| Insight Dynamics Llc | |
|
413 E Spring St Boonville MO 65233-1573 | |
| (166) 088-2640 | |
| Not Available |
| Full Name | Insight Dynamics Llc |
|---|---|
| Speciality | Social Worker |
| Location | 413 E Spring St, Boonville, Missouri |
| Authorized Official Name and Position | Aneisa Lynn Sherrill-mattox (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6608826400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Insight Dynamics Llc 413 E Spring St Boonville MO 65233-1573 Ph: (166) 088-2640 | Insight Dynamics Llc 413 E Spring St Boonville MO 65233-1573 Ph: (166) 088-2640 |
| NPI Number | 1710698402 |
|---|---|
| Provider Enumeration Date | 12/13/2022 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Medicare PECOS PAC ID | 9335519727 |
|---|---|
| Medicare Enrollment ID | O20221229000815 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710698402 | NPI | - | NPPES |
| 490078150 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Aneisa Lynn Sherrill-mattox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750788022 PECOS PAC ID: 9335573088 Enrollment ID: I20200106000943 |
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