| Tender Hearts Child Therapy Center | |
|
2909 Independence St Cape Girardeau MO 63703-5044 | |
| (573) 803-1402 | |
| (573) 803-1405 |
| Full Name | Tender Hearts Child Therapy Center |
|---|---|
| Speciality | Counselor |
| Location | 2909 Independence St, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Shannon N Anderson (MANAGING MEMBER/OWNER) |
| Authorized Official Contact | 5738031402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tender Hearts Child Therapy Center 2909 Independence St Cape Girardeau MO 63703-5044 Ph: (573) 803-1402 | Tender Hearts Child Therapy Center 2909 Independence St Cape Girardeau MO 63703-5044 Ph: (573) 803-1402 |
| NPI Number | 1568777910 |
|---|---|
| Provider Enumeration Date | 08/10/2010 |
| Last Update Date | 03/21/2013 |
| Medicare PECOS PAC ID | 2264691500 |
|---|---|
| Medicare Enrollment ID | O20120306000995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568777910 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2008014362 (Missouri) | Primary |
| Provider Name | Charlotte Ann Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083071039 PECOS PAC ID: 8527366012 Enrollment ID: I20160418000626 |
| Provider Name | Anthony E Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205854320 PECOS PAC ID: 9032569454 Enrollment ID: I20231228000271 |
| Provider Name | Cecelia F Bradley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851484539 PECOS PAC ID: 9234589524 Enrollment ID: I20231228003343 |
| Provider Name | Harold L Busch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639605405 PECOS PAC ID: 0143670448 Enrollment ID: I20231228003406 |
| Provider Name | Derek Stricklin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598044083 PECOS PAC ID: 7911357181 Enrollment ID: I20231229002235 |
| Provider Name | Catherine W Devaney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902996879 PECOS PAC ID: 7214387273 Enrollment ID: I20240103001920 |
| Provider Name | Shannon N Anderson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093975971 PECOS PAC ID: 7416116769 Enrollment ID: I20240103002420 |
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