| Midwest Counseling And Assessment, Llc | |
|
408 Washington Ave Ste 107 West Plains MO 65775-3404 | |
| (417) 255-8790 | |
| (417) 222-6991 |
| Full Name | Midwest Counseling And Assessment, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 408 Washington Ave Ste 107, West Plains, Missouri |
| Authorized Official Name and Position | Jennifer Long (OWNER, LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 4174252565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Counseling And Assessment, Llc 408 Washington Ave Ste 107 West Plains MO 65775-3404 Ph: (417) 255-8790 | Midwest Counseling And Assessment, Llc 408 Washington Ave Ste 107 West Plains MO 65775-3404 Ph: (417) 255-8790 |
| NPI Number | 1841720547 |
|---|---|
| Provider Enumeration Date | 06/14/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 7911276530 |
|---|---|
| Medicare Enrollment ID | O20170712003474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841720547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2010030531 (Missouri) | Primary |
| Provider Name | Jennifer Suzanne Long |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639280688 PECOS PAC ID: 3678797842 Enrollment ID: I20170712003594 |
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