| Preferred Family Healthcare, Inc | |
|
900 E Laharpe St Kirksville MO 63501-4520 | |
| (660) 665-1962 | |
| (660) 665-3989 |
| Full Name | Preferred Family Healthcare, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 900 E Laharpe St, Kirksville, Missouri |
| Authorized Official Name and Position | Mark Conover (CHIEF REVENUE OFFICER) |
| Authorized Official Contact | 5736031460 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Family Healthcare, Inc 1601 Old South River Rd Saint Charles MO 63303-4120 Ph: (636) 224-1210 | Preferred Family Healthcare, Inc 900 E Laharpe St Kirksville MO 63501-4520 Ph: (660) 665-1962 |
| NPI Number | 1649474206 |
|---|---|
| Provider Enumeration Date | 06/14/2007 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 0244256246 |
|---|---|
| Medicare Enrollment ID | O20051019000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649474206 | NPI | - | NPPES |
| PARENT NPI | Other | FOR BILLING ADDRESS ONLY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6300-9238 (Missouri) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | 6300-11443 (Missouri) | Secondary |
| Provider Name | Lyreva J Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548246747 PECOS PAC ID: 6305747726 Enrollment ID: I20040119000414 |
| Provider Name | Marilyn Sue Frankenbach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841479805 PECOS PAC ID: 5496641516 Enrollment ID: I20040225000924 |
| Provider Name | Brent R Palmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952414096 PECOS PAC ID: 7416944343 Enrollment ID: I20040430000490 |
| Provider Name | John T Sylvara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881662724 PECOS PAC ID: 4587623830 Enrollment ID: I20041012000904 |
| Provider Name | Anil Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912961558 PECOS PAC ID: 9335032028 Enrollment ID: I20050118000005 |
| Provider Name | Cindy G Ruttan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699718254 PECOS PAC ID: 4183726821 Enrollment ID: I20070226000774 |
| Provider Name | Robert Bynum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952348690 PECOS PAC ID: 3971600255 Enrollment ID: I20070522000057 |
| Provider Name | Mary M Brant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356407720 PECOS PAC ID: 0446357396 Enrollment ID: I20070529000611 |
| Provider Name | Katarzyna Derlukiewicz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033378708 PECOS PAC ID: 1153497862 Enrollment ID: I20080904000009 |
| Provider Name | Tonya N Stamper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811144413 PECOS PAC ID: 7618030230 Enrollment ID: I20090108000286 |
| Provider Name | Joseph L Spalding |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073554085 PECOS PAC ID: 6507910163 Enrollment ID: I20090817000104 |
| Provider Name | Corrie J Willis |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1891771010 PECOS PAC ID: 1052332848 Enrollment ID: I20091007000601 |
| Provider Name | Amir Sahba Jalali |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346334166 PECOS PAC ID: 5496947780 Enrollment ID: I20101005000662 |
| Provider Name | Drew D Shoemaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851313399 PECOS PAC ID: 2961310826 Enrollment ID: I20101027000925 |
| Provider Name | Karl E. Shanstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689815201 PECOS PAC ID: 1951570399 Enrollment ID: I20110801000954 |
| Provider Name | Chanda Herron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225463490 PECOS PAC ID: 4880821925 Enrollment ID: I20131216001214 |
| Provider Name | Geannette L Walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215125448 PECOS PAC ID: 5698090819 Enrollment ID: I20150211000496 |
| Provider Name | Paul E Glaser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316020738 PECOS PAC ID: 9133207186 Enrollment ID: I20150505002707 |
| Provider Name | Betty Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821331984 PECOS PAC ID: 8921313305 Enrollment ID: I20150813011220 |
| Provider Name | Sarfaraz Jasdanwala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851646665 PECOS PAC ID: 8426364258 Enrollment ID: I20150825003318 |
| Provider Name | Brandy Diane Yarnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457803363 PECOS PAC ID: 8527347772 Enrollment ID: I20161111000685 |
| Provider Name | Brooke D Gipson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104291350 PECOS PAC ID: 6709153380 Enrollment ID: I20170602000707 |
| Provider Name | Amy M Linss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568709228 PECOS PAC ID: 5991078628 Enrollment ID: I20170831002066 |
| Provider Name | Lisa Tuttle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568830503 PECOS PAC ID: 5193086353 Enrollment ID: I20180302001847 |
| Provider Name | Shelby Sue Leppin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801381876 PECOS PAC ID: 9133472632 Enrollment ID: I20181031000646 |
| Provider Name | Andrea C Jasdanwala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619405602 PECOS PAC ID: 9335484369 Enrollment ID: I20181220000184 |
| Provider Name | Hervey Mac Madden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710017686 PECOS PAC ID: 2860719549 Enrollment ID: I20190205002135 |
| Provider Name | Grace Marie Carder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386064251 PECOS PAC ID: 4082955349 Enrollment ID: I20190415001105 |
| Provider Name | Erin Elizabeth Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740742998 PECOS PAC ID: 9537400726 Enrollment ID: I20190417000810 |
| Provider Name | Angela M Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437402856 PECOS PAC ID: 9335481340 Enrollment ID: I20190423001377 |
| Provider Name | Lauren Whitaker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750756920 PECOS PAC ID: 3678815156 Enrollment ID: I20190502001530 |
| Provider Name | Daniel W Ulrich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508075698 PECOS PAC ID: 0547285355 Enrollment ID: I20190530001379 |
| Provider Name | William R Enochs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144617978 PECOS PAC ID: 4880996594 Enrollment ID: I20190829002064 |
| Provider Name | Tracy Francis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073022844 PECOS PAC ID: 5991037863 Enrollment ID: I20191025000231 |
| Provider Name | Otuomasirichi E Onyema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861048225 PECOS PAC ID: 6709842073 Enrollment ID: I20191112000991 |
| Provider Name | Sailaja Bysani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194907907 PECOS PAC ID: 0648607275 Enrollment ID: I20200220002301 |
| Provider Name | Amy Jeanne Foreman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396154704 PECOS PAC ID: 9234472325 Enrollment ID: I20200501001076 |
| Provider Name | Casey Dawn Holt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841636362 PECOS PAC ID: 6608206271 Enrollment ID: I20200501001922 |
| Provider Name | Ian Leonard Pearson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225490881 PECOS PAC ID: 1658665211 Enrollment ID: I20201016001417 |
| Provider Name | Heather Anne Mahsman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952968141 PECOS PAC ID: 1456680552 Enrollment ID: I20210421000932 |
| Provider Name | Mandy Lee Eisenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659931491 PECOS PAC ID: 0941605489 Enrollment ID: I20210823001235 |
| Provider Name | Pamela Barrigar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134571672 PECOS PAC ID: 5991048290 Enrollment ID: I20210823002636 |
| Provider Name | Amy Bue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326696360 PECOS PAC ID: 2466887518 Enrollment ID: I20211019001005 |
| Provider Name | Suzanne Mardell Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942883269 PECOS PAC ID: 9335537778 Enrollment ID: I20211103003286 |
| Provider Name | Dianna Lynn Phares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922335769 PECOS PAC ID: 9234472101 Enrollment ID: I20211202000649 |
| Provider Name | Elizabeth Lockhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841954328 PECOS PAC ID: 0042603680 Enrollment ID: I20220203001318 |
| Provider Name | Christina N Reynolds |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225322514 PECOS PAC ID: 5799075560 Enrollment ID: I20220330000203 |
| Provider Name | Amit Jagtiani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225559016 PECOS PAC ID: 7113306770 Enrollment ID: I20220628002060 |
| Provider Name | James Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730771320 PECOS PAC ID: 9032526074 Enrollment ID: I20220729000460 |
| Provider Name | Carissa Danielle Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306592696 PECOS PAC ID: 0749662880 Enrollment ID: I20220805000650 |
| Provider Name | Tjitske Gay Tubbergen-maglio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235468786 PECOS PAC ID: 5092183624 Enrollment ID: I20221201001680 |
| Provider Name | Leslie Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730630930 PECOS PAC ID: 1951770395 Enrollment ID: I20221207001611 |
| Provider Name | Megan Marie Kruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477274827 PECOS PAC ID: 5890166219 Enrollment ID: I20230123002741 |
| Provider Name | Mary M Brant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356407720 PECOS PAC ID: 0446357396 Enrollment ID: I20230503002144 |
| Provider Name | Diane Michelle Zimmerman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356053045 PECOS PAC ID: 9931565785 Enrollment ID: I20230519002530 |
| Provider Name | Jean Sokora |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053002485 PECOS PAC ID: 5395108096 Enrollment ID: I20230829000949 |
| Provider Name | Alicia Marie Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669039426 PECOS PAC ID: 6103280078 Enrollment ID: I20230911002600 |
| Provider Name | Erica Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770264327 PECOS PAC ID: 3173987484 Enrollment ID: I20230919002775 |
| Provider Name | Jennifer Renee Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508546219 PECOS PAC ID: 9537523816 Enrollment ID: I20230920000620 |
| Provider Name | Angela D Rowden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396457081 PECOS PAC ID: 0840647517 Enrollment ID: I20231117000915 |
| Provider Name | Virginia Marie King |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1609469626 PECOS PAC ID: 9032567557 Enrollment ID: I20231122000518 |
| Provider Name | Bridgett L Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952938367 PECOS PAC ID: 0941658306 Enrollment ID: I20231122002481 |
| Provider Name | Jessica Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316467210 PECOS PAC ID: 5890142012 Enrollment ID: I20231127002053 |
| Provider Name | Jeanne Bea Gellings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366587032 PECOS PAC ID: 1658729892 Enrollment ID: I20231128002304 |
| Provider Name | Connie J Cameron |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295003275 PECOS PAC ID: 2769830942 Enrollment ID: I20231129002289 |
| Provider Name | Matthew C Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245802735 PECOS PAC ID: 8022466176 Enrollment ID: I20231129003189 |
| Provider Name | James Hicks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164199931 PECOS PAC ID: 7719335744 Enrollment ID: I20231130002399 |
| Provider Name | Stacey Samantha Juilfs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003342783 PECOS PAC ID: 9234586181 Enrollment ID: I20231204000362 |
| Provider Name | Krysten Jolynn Jarman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083295620 PECOS PAC ID: 4486002367 Enrollment ID: I20231204000876 |
| Provider Name | Alice D Leckenby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629523469 PECOS PAC ID: 3678921566 Enrollment ID: I20231204001260 |
| Provider Name | Lisa Arnett Holmes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548926454 PECOS PAC ID: 5092163998 Enrollment ID: I20231204001863 |
| Provider Name | Shonna Cherice Sommer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356907158 PECOS PAC ID: 7810346681 Enrollment ID: I20231206001263 |
| Provider Name | Katie L Peters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447929625 PECOS PAC ID: 9638528417 Enrollment ID: I20231206001835 |
| Provider Name | Dianna I Herzinger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841822723 PECOS PAC ID: 7214386994 Enrollment ID: I20231206002102 |
| Provider Name | Susan G Buckallew |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386952604 PECOS PAC ID: 5395194096 Enrollment ID: I20231206002972 |
| Provider Name | Debbie Elaine Ezenwa |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053342097 PECOS PAC ID: 5193173110 Enrollment ID: I20231207003573 |
| Provider Name | Bruce Arno Fleischer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508333881 PECOS PAC ID: 1658720214 Enrollment ID: I20231208000992 |
| Provider Name | Katie Lynn Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356966188 PECOS PAC ID: 1355790825 Enrollment ID: I20231208001568 |
| Provider Name | Kaitlynn M Dexter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518476241 PECOS PAC ID: 7810346202 Enrollment ID: I20231211001897 |
| Provider Name | Angelana Marie Kreeger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457565145 PECOS PAC ID: 0941659114 Enrollment ID: I20231213001762 |
| Provider Name | Stacey D Middleton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053766063 PECOS PAC ID: 3577912500 Enrollment ID: I20231215000576 |
| Provider Name | Gregory G Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942771944 PECOS PAC ID: 3072962042 Enrollment ID: I20231215002229 |
| Provider Name | Christy M Power |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962747816 PECOS PAC ID: 5890144869 Enrollment ID: I20231215002231 |
| Provider Name | Jody M Mueller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124373584 PECOS PAC ID: 0840649166 Enrollment ID: I20231215002420 |
| Provider Name | Felicia M Lincoln |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821335340 PECOS PAC ID: 8022467364 Enrollment ID: I20231215002556 |
| Provider Name | April Leigh Snodgrass |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356672844 PECOS PAC ID: 9133578040 Enrollment ID: I20231218000283 |
| Provider Name | Summer M Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053919993 PECOS PAC ID: 2264881184 Enrollment ID: I20231218000584 |
| Provider Name | Geries S Shaheen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164892253 PECOS PAC ID: 9638528573 Enrollment ID: I20231218001405 |
| Provider Name | Paul E. Niemoeller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164557468 PECOS PAC ID: 4688023542 Enrollment ID: I20231218002291 |
| Provider Name | Kayla Noelle Theberge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013676865 PECOS PAC ID: 9032568993 Enrollment ID: I20231218002310 |
| Provider Name | Titus D Tubb |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194288605 PECOS PAC ID: 8729437694 Enrollment ID: I20231218002929 |
| Provider Name | Carrie Ann Potts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124489745 PECOS PAC ID: 1355790221 Enrollment ID: I20231218003001 |
| Provider Name | Lenae S Tippett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427475623 PECOS PAC ID: 2163871385 Enrollment ID: I20231218003085 |
| Provider Name | Raelene M. Gilbert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841690187 PECOS PAC ID: 6800245788 Enrollment ID: I20231218003476 |
| Provider Name | Wendy M Straube |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003979758 PECOS PAC ID: 3678922564 Enrollment ID: I20231218003683 |
| Provider Name | Kaitlyn A Hagee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811650773 PECOS PAC ID: 4486004389 Enrollment ID: I20231219000224 |
| Provider Name | Walter Vincent Winn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376857375 PECOS PAC ID: 7911357827 Enrollment ID: I20231219000341 |
| Provider Name | Steven C Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811216336 PECOS PAC ID: 8921458852 Enrollment ID: I20231219000975 |
| Provider Name | Richard Lee Roe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043995053 PECOS PAC ID: 2466802301 Enrollment ID: I20231219001428 |
| Provider Name | Mario A Aguilar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457959702 PECOS PAC ID: 6406206283 Enrollment ID: I20231219003530 |
| Provider Name | Anita B Polzin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053721290 PECOS PAC ID: 8527415561 Enrollment ID: I20231219003922 |
| Provider Name | Stacie Lynn Whitaker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306104799 PECOS PAC ID: 8123478955 Enrollment ID: I20231220001040 |
| Provider Name | Gregory Michael Lowes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720275860 PECOS PAC ID: 3274983945 Enrollment ID: I20231220003405 |
| Provider Name | Jaimee E Hall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730623331 PECOS PAC ID: 7012367659 Enrollment ID: I20231222002034 |
| Provider Name | Jaclyn Kay Woods |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114545829 PECOS PAC ID: 3971953464 Enrollment ID: I20231226000524 |
| Provider Name | Angela B Warfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215587456 PECOS PAC ID: 6002266210 Enrollment ID: I20240102000303 |
| Provider Name | Joseph A Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023664810 PECOS PAC ID: 5799135836 Enrollment ID: I20240102001512 |
| Provider Name | Sarah N Jacyna |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700549094 PECOS PAC ID: 2668823675 Enrollment ID: I20240103004238 |
| Provider Name | Rebecca C Gunn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013538560 PECOS PAC ID: 5597116517 Enrollment ID: I20240103004609 |
| Provider Name | Peggy Suzanne Probst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215146402 PECOS PAC ID: 8123479169 Enrollment ID: I20240104000138 |
| Provider Name | Laura E Nickelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235259664 PECOS PAC ID: 2163873134 Enrollment ID: I20240104001409 |
| Provider Name | Lindsey N Stewart-montague |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609382548 PECOS PAC ID: 8224489067 Enrollment ID: I20240105003003 |
| Provider Name | Jennifer L Wesley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790295806 PECOS PAC ID: 7214388776 Enrollment ID: I20240109002230 |
| Provider Name | Rebecca Lyn Batten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801407283 PECOS PAC ID: 0042662991 Enrollment ID: I20240117000719 |
| Provider Name | Melanie M Tipton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790358547 PECOS PAC ID: 7113370511 Enrollment ID: I20240201003103 |
| Provider Name | Mallory Loren Cook Ahmann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639834138 PECOS PAC ID: 6608219654 Enrollment ID: I20240207001657 |
| Provider Name | Chelsea E Neel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144856980 PECOS PAC ID: 2365888682 Enrollment ID: I20240308003120 |
| Provider Name | Reena Dennis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659815900 PECOS PAC ID: 3173961794 Enrollment ID: I20240402002186 |
| Provider Name | Erin J Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326812215 PECOS PAC ID: 2769821479 Enrollment ID: I20240415001524 |
| Provider Name | Katelyn Brianna Crossgrove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255928271 PECOS PAC ID: 9436599578 Enrollment ID: I20240506004193 |
| Provider Name | Chris D Polzin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922375088 PECOS PAC ID: 5395170302 Enrollment ID: I20240508002074 |
| Provider Name | Darla Jo Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255988705 PECOS PAC ID: 5799227039 Enrollment ID: I20240603001186 |
Preferred Family Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Laharpe St, Kirksville, MO 63501 Phone: 660-665-1962 Fax: 660-665-3989 | |
Preferred Family Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Laharpe St, Kirksville, MO 63501 Phone: 660-665-1962 Fax: 660-665-3989 | |
Northeast Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 Pfeiffer Ave, Kirksville, MO 63501 Phone: 660-627-3621 Fax: 660-627-5798 | |
Preferred Family Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1101 Jamison St, Kirksville, MO 63501 Phone: 660-665-1962 Fax: 660-627-0642 | |
Northeast Family Health Clinics Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1416 Crown Drive, Kirksville, MO 63501 Phone: 660-627-5757 Fax: 660-627-5802 | |
Preferred Family Healthcare Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Laharpe St, Kirksville, MO 63501 Phone: 660-665-1962 Fax: 660-665-3989 | |
A T Still University Of Health Sciences Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 800 W Jefferson St, Kirksville, MO 63501 Phone: 660-626-2739 Fax: 660-626-2150 |