| Mercy Neuropsychology Services, Llc | |
|
615 S New Ballas Rd Neuropsychology - Ground Floor Saint Louis MO 63141-8221 | |
| (314) 251-4683 | |
| (314) 251-4380 |
| Full Name | Mercy Neuropsychology Services, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 615 S New Ballas Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Jeffrey A. Johnston (PRESIDENT, MERCY HOSPITAL ST. LOUIS) |
| Authorized Official Contact | 3142511932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Neuropsychology Services, Llc 615 S New Ballas Rd Neuropsychology - Ground Floor Saint Louis MO 63141-8221 Ph: (314) 251-4683 | Mercy Neuropsychology Services, Llc 615 S New Ballas Rd Neuropsychology - Ground Floor Saint Louis MO 63141-8221 Ph: (314) 251-4683 |
| NPI Number | 1932377496 |
|---|---|
| Provider Enumeration Date | 02/18/2008 |
| Last Update Date | 11/19/2018 |
| Medicare PECOS PAC ID | 3072685106 |
|---|---|
| Medicare Enrollment ID | O20080708000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932377496 | NPI | - | NPPES |
| 509008009 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | John Wright |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265448542 PECOS PAC ID: 9830109230 Enrollment ID: I20060501000125 |
| Provider Name | Kristen A Sands |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477622553 PECOS PAC ID: 9537231519 Enrollment ID: I20080708000575 |
| Provider Name | Angela N Capps |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992093447 PECOS PAC ID: 2365615812 Enrollment ID: I20111031000023 |
| Provider Name | Victoria Herberger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912374398 PECOS PAC ID: 0446568596 Enrollment ID: I20151009000534 |
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