| Southeast Mo Mental Health Center | |
|
1010 W Columbia St Farmington MO 63640-2902 | |
| (573) 218-6792 | |
| (573) 218-6703 |
| Full Name | Southeast Mo Mental Health Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1010 W Columbia St, Farmington, Missouri |
| Authorized Official Name and Position | Molly Jane Boeckmann (DIRECTOR ADMINISTRATIVE SERVICES) |
| Authorized Official Contact | 5737514055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Mo Mental Health Center 1706 E Elm St Jefferson City MO 65101-4130 Ph: (573) 751-3398 | Southeast Mo Mental Health Center 1010 W Columbia St Farmington MO 63640-2902 Ph: (573) 218-6792 |
| NPI Number | 1437106705 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 09/03/2020 |
| Certification Date | 09/03/2020 |
| Medicare PECOS PAC ID | 1456254226 |
|---|---|
| Medicare Enrollment ID | O20040218001002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437106705 | NPI | - | NPPES |
| 500490206 | Medicaid | MO |
| Provider Name | Amalakumar Dominic Augustine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871579896 PECOS PAC ID: 7214830843 Enrollment ID: I20040130000122 |
| Provider Name | Veera N Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336257237 PECOS PAC ID: 1557256583 Enrollment ID: I20040218000955 |
| Provider Name | Manisha Lele |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508924077 PECOS PAC ID: 4981647906 Enrollment ID: I20050609000777 |
| Provider Name | Praveen S Nimmagadda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689722951 PECOS PAC ID: 4183630494 Enrollment ID: I20060223000552 |
| Provider Name | Ralph Leigh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164449708 PECOS PAC ID: 1759445422 Enrollment ID: I20090123000403 |
| Provider Name | George A Oliver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851459341 PECOS PAC ID: 2264586676 Enrollment ID: I20090820000046 |
| Provider Name | Sekhar Vangala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679774962 PECOS PAC ID: 7113073628 Enrollment ID: I20090925000105 |
| Provider Name | Patricia K Koppeis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831205566 PECOS PAC ID: 6305988577 Enrollment ID: I20100126000734 |
| Provider Name | Jamesy C Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053632935 PECOS PAC ID: 4688708514 Enrollment ID: I20100813001089 |
| Provider Name | Bonnie K Howley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285795849 PECOS PAC ID: 3577687516 Enrollment ID: I20100827000854 |
| Provider Name | Hungi P Sripal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538229901 PECOS PAC ID: 0042335283 Enrollment ID: I20100913000188 |
| Provider Name | Sequita M Morris |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1467414268 PECOS PAC ID: 5890754022 Enrollment ID: I20110119000266 |
| Provider Name | Kathleen M Hammond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508145954 PECOS PAC ID: 1153598214 Enrollment ID: I20120113000130 |
| Provider Name | Stacy Lynn Neff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639370901 PECOS PAC ID: 9537213301 Enrollment ID: I20130424000717 |
| Provider Name | Pooja Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578728218 PECOS PAC ID: 3870736242 Enrollment ID: I20130904000466 |
| Provider Name | Nezar Ali El-ruwie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649408659 PECOS PAC ID: 6507082997 Enrollment ID: I20140721001028 |
| Provider Name | Angela Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841685989 PECOS PAC ID: 7810216611 Enrollment ID: I20150429000438 |
| Provider Name | Dustin Morton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164062998 PECOS PAC ID: 0840627733 Enrollment ID: I20200306000255 |
| Provider Name | Gopinath Gorthy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831534460 PECOS PAC ID: 1759687353 Enrollment ID: I20211104002763 |
Southeast Missouri Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5536 Hwy 32, Farmington, MO 63640 Phone: 573-756-5749 Fax: 573-431-5205 | |
Womack Counseling Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 503 Potosi St, Farmington, MO 63640 Phone: 573-756-1602 Fax: 573-756-1603 | |
Bjc Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1085 Maple Street, Farmington, MO 63640 Phone: 573-756-5353 Fax: 573-756-4557 | |
Templar Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 E Columbia St Ste B9, Farmington, MO 63640 Phone: 573-953-3005 Fax: 844-458-8348 | |
T-k Ranch Equine Assisted Coaching Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17885 Hart Pinkston Rd, Farmington, MO 63640 Phone: 573-747-9115 Fax: 855-209-5615 | |
Bjc Behavioral Southeast Pharmacy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1085 Maple St, Farmington, MO 63640 Phone: 573-756-5353 | |
Bjc Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1085 Maple St, Farmington, MO 63640 Phone: 573-756-5353 Fax: 573-756-4557 |