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3037 Lexington Ave Cape Girardeau MO 63701-2602 | |
| (573) 271-2008 | |
| (573) 240-9737 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3037 Lexington Ave, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Travis Smith (DIRECTOR) |
| Authorized Official Contact | 5732712008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3037 Lexington Ave Cape Girardeau MO 63701-2602 Ph: (573) 271-2008 | 3037 Lexington Ave Cape Girardeau MO 63701-2602 Ph: (573) 271-2008 |
| NPI Number | 1669803540 |
|---|---|
| Provider Enumeration Date | 12/03/2013 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669803540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 2009023490 (Missouri) | Primary |
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