| St Louis Forensic Treatment Center | |
|
5300 Arsenal St Saint Louis MO 63139-1463 | |
| (314) 644-8000 | |
| Not Available |
| Full Name | St Louis Forensic Treatment Center |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5300 Arsenal St, Saint Louis, Missouri |
| Authorized Official Name and Position | Molly Jane Boeckmann (DIRECTOR OF 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 |
|---|---|
| St Louis Forensic Treatment Center 1706 E Elm St Jefferson City MO 65101-4130 Ph: (573) 751-3398 | St Louis Forensic Treatment Center 5300 Arsenal St Saint Louis MO 63139-1463 Ph: (314) 644-8000 |
| NPI Number | 1427002013 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 12/01/2020 |
| Certification Date | 12/01/2020 |
| Medicare PECOS PAC ID | 1456254226 |
|---|---|
| Medicare Enrollment ID | O20041208000430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427002013 | NPI | - | NPPES |
| 501500003 | Medicaid | MO |
| Provider Name | Omar H Quadri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811071665 PECOS PAC ID: 7113826876 Enrollment ID: I20040102000198 |
| Provider Name | Rakhshanda Hassan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285718163 PECOS PAC ID: 6305732678 Enrollment ID: I20041004000670 |
| Provider Name | Lisa Parker Scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275573065 PECOS PAC ID: 8224078076 Enrollment ID: I20050511000272 |
| Provider Name | Manisha Lele |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508924077 PECOS PAC ID: 4981647906 Enrollment ID: I20050609000777 |
| Provider Name | Tracey R Fintel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871813584 PECOS PAC ID: 2365574183 Enrollment ID: I20100714000667 |
| Provider Name | Ilir Polovina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952540999 PECOS PAC ID: 5991820102 Enrollment ID: I20100910001149 |
| Provider Name | Sadashiv D Parwatikar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992793145 PECOS PAC ID: 8820234701 Enrollment ID: I20130419000173 |
| Provider Name | Michelle Hoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801336243 PECOS PAC ID: 4486929759 Enrollment ID: I20171012001685 |
| Provider Name | Amy M Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841277357 PECOS PAC ID: 5092742338 Enrollment ID: I20201012001590 |
| Provider Name | Agnieszka Milczarek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295175677 PECOS PAC ID: 0648409383 Enrollment ID: I20210119000203 |
| Provider Name | Meryl K Brune |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447770052 PECOS PAC ID: 8022342997 Enrollment ID: I20211014000155 |
| Provider Name | Ali Alizadeh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588196117 PECOS PAC ID: 4082039466 Enrollment ID: I20211019000247 |
| Provider Name | Himani S Marathe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336676840 PECOS PAC ID: 2264700152 Enrollment ID: I20211103000320 |
| Provider Name | Sally Crisp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316603640 PECOS PAC ID: 7719370576 Enrollment ID: I20220131002427 |
| Provider Name | Leah Nicole Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700215753 PECOS PAC ID: 3072908300 Enrollment ID: I20220427002763 |
| Provider Name | Alexander Christian Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376296269 PECOS PAC ID: 5890174288 Enrollment ID: I20220615000188 |
| Provider Name | Sean White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568197507 PECOS PAC ID: 4183096746 Enrollment ID: I20230207003104 |
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