| Waldo Psychological Services Llc | |
|
3904 Sw Windsong Dr Lees Summit MO 64082-4051 | |
| (660) 596-2400 | |
| Not Available |
| Full Name | Waldo Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3904 Sw Windsong Dr, Lees Summit, Missouri |
| Authorized Official Name and Position | Susan Waldo (PRESIDENT) |
| Authorized Official Contact | 6605962400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waldo Psychological Services Llc Po Box 1547 Sedalia MO 65302-1547 Ph: (660) 826-5960 | Waldo Psychological Services Llc 3904 Sw Windsong Dr Lees Summit MO 64082-4051 Ph: (660) 596-2400 |
| NPI Number | 1013139203 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 08/27/2021 |
| Certification Date | 08/27/2021 |
| Medicare PECOS PAC ID | 6305944711 |
|---|---|
| Medicare Enrollment ID | O20070608000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013139203 | NPI | - | NPPES |
| 26423017 | Other | MO | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Susan L Waldo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174697338 PECOS PAC ID: 6103924089 Enrollment ID: I20070531000598 |
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