| Residential Psychiatric Services, Inc. | |
|
1269 Doctors Dr Farmington MO 63640-2947 | |
| (573) 664-1146 | |
| (573) 664-1149 |
| Full Name | Residential Psychiatric Services, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 1269 Doctors Dr, Farmington, Missouri |
| Authorized Official Name and Position | Mona Kay Evans (PRESIDENT) |
| Authorized Official Contact | 5737834292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Residential Psychiatric Services, Inc. 1269 Doctors Dr Farmington MO 63640-2947 Ph: (573) 664-1146 | Residential Psychiatric Services, Inc. 1269 Doctors Dr Farmington MO 63640-2947 Ph: (573) 664-1146 |
| NPI Number | 1467453894 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 08/29/2016 |
| Medicare PECOS PAC ID | 3870576390 |
|---|---|
| Medicare Enrollment ID | O20040608000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467453894 | NPI | - | NPPES |
| 850830902 | Other | MO | DMH |
| 500830906 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 002060 (Missouri) | Primary |
| Provider Name | Mona K Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407886864 PECOS PAC ID: 7719960236 Enrollment ID: I20040608000003 |
| Provider Name | Karen L Monroe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457564023 PECOS PAC ID: 5597893834 Enrollment ID: I20100507000196 |
| Provider Name | Sarah L Henderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083920599 PECOS PAC ID: 2365637279 Enrollment ID: I20101117000208 |
| Provider Name | Deborah L Bonham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023497468 PECOS PAC ID: 5395066195 Enrollment ID: I20150604002610 |
| Provider Name | Erica L Wofford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619981040 PECOS PAC ID: 8022446046 Enrollment ID: I20200325000556 |
| Provider Name | Georgia L Roth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073146957 PECOS PAC ID: 2668800681 Enrollment ID: I20200325000569 |
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