| Spring Grove Counseling | |
|
211 A Oscar Drive Jefferson City MO 65101-5167 | |
| (573) 635-8299 | |
| (573) 635-4629 |
| Full Name | Spring Grove Counseling |
|---|---|
| Speciality | Counselor |
| Location | 211 A Oscar Drive, Jefferson City, Missouri |
| Authorized Official Name and Position | Judy Kaye Wieberg (OWNER/DIRECTOR) |
| Authorized Official Contact | 5736358299 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spring Grove Counseling 211 A Oscar Drive Jefferson City MO 65101-5167 Ph: (573) 635-8299 | Spring Grove Counseling 211 A Oscar Drive Jefferson City MO 65101-5167 Ph: (573) 635-8299 |
| NPI Number | 1922352012 |
|---|---|
| Provider Enumeration Date | 10/29/2012 |
| Last Update Date | 10/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922352012 | NPI | - | NPPES |
| 493361109 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 001621 (Missouri) | Primary |
| 104100000X | Social Worker | 002100 (Missouri) | Secondary |
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