| Rejuvenate Inc | |
|
400 Sw Longview Blvd Ste 160 Lees Summit MO 64081-2112 | |
| (816) 761-3944 | |
| (866) 335-7993 |
| Full Name | Rejuvenate Inc |
|---|---|
| Speciality | Psychologist |
| Location | 400 Sw Longview Blvd Ste 160, Lees Summit, Missouri |
| Authorized Official Name and Position | Scott J Symes (OWNER) |
| Authorized Official Contact | 8168126820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rejuvenate Inc 400 Sw Longview Blvd Ste 160 Lees Summit MO 64081-2112 Ph: (816) 761-3944 | Rejuvenate Inc 400 Sw Longview Blvd Ste 160 Lees Summit MO 64081-2112 Ph: (816) 761-3944 |
| NPI Number | 1669617841 |
|---|---|
| Provider Enumeration Date | 12/02/2008 |
| Last Update Date | 01/11/2012 |
| Medicare PECOS PAC ID | 0244395762 |
|---|---|
| Medicare Enrollment ID | O20090217000673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669617841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Scott J Symes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063496487 PECOS PAC ID: 3971575192 Enrollment ID: I20041102000008 |
| Provider Name | Adam Fellows |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285686089 PECOS PAC ID: 6406914811 Enrollment ID: I20081028000779 |
| Provider Name | Tiffany M Fellows |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710939525 PECOS PAC ID: 2769547280 Enrollment ID: I20090217000704 |
| Provider Name | Twila Preston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841331683 PECOS PAC ID: 8426026428 Enrollment ID: I20161116001495 |
| Provider Name | Andrew I Whitmore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306916077 PECOS PAC ID: 1557556834 Enrollment ID: I20170830001579 |
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