| Lifesong For Growth And Wellness Llc | |
|
3401 W Truman Blvd Ste 100 Jefferson City MO 65109-5752 | |
| (573) 644-7909 | |
| (573) 644-7908 |
| Full Name | Lifesong For Growth And Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 3401 W Truman Blvd, Jefferson City, Missouri |
| Authorized Official Name and Position | Deborah Middleton (PARTNER) |
| Authorized Official Contact | 5736447909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesong For Growth And Wellness Llc 3401 W Truman Blvd Ste 100 Jefferson City MO 65109-5752 Ph: (573) 644-7909 | Lifesong For Growth And Wellness Llc 3401 W Truman Blvd Ste 100 Jefferson City MO 65109-5752 Ph: (573) 644-7909 |
| NPI Number | 1114228335 |
|---|---|
| Provider Enumeration Date | 11/04/2010 |
| Last Update Date | 05/02/2014 |
| Medicare PECOS PAC ID | 0446430698 |
|---|---|
| Medicare Enrollment ID | O20110207000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114228335 | NPI | - | NPPES |
| Provider Name | Laurel A Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538105986 PECOS PAC ID: 2062485766 Enrollment ID: I20040819000228 |
| Provider Name | Deborah M Middleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578621009 PECOS PAC ID: 1052415106 Enrollment ID: I20070329000017 |
| Provider Name | Richard Paul Lillard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033205125 PECOS PAC ID: 2466540554 Enrollment ID: I20071127000403 |
| Provider Name | Lori M Dreyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578813895 PECOS PAC ID: 3779733142 Enrollment ID: I20121019000325 |
| Provider Name | Jonathan F Rhodes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962805127 PECOS PAC ID: 4486875655 Enrollment ID: I20141103000077 |
| Provider Name | Lisa J Snow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750705638 PECOS PAC ID: 3274851209 Enrollment ID: I20150423000109 |
| Provider Name | Jessica R Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275154825 PECOS PAC ID: 7214352772 Enrollment ID: I20200731001164 |
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