| White Oak Psychiatric Services | |
|
4045 Ne Lakewood Way Suite 130 Lees Summit MO 64064-1799 | |
| (816) 886-2184 | |
| (816) 886-2397 |
| Full Name | White Oak Psychiatric Services |
|---|---|
| Speciality | Psychologist |
| Location | 4045 Ne Lakewood Way, Lees Summit, Missouri |
| Authorized Official Name and Position | Mohammed Azher Mirza (OWNER) |
| Authorized Official Contact | 8162285335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Oak Psychiatric Services 4045 Ne Lakewood Way Suite 130 Lees Summit MO 64064-1799 Ph: (816) 886-2184 | White Oak Psychiatric Services 4045 Ne Lakewood Way Suite 130 Lees Summit MO 64064-1799 Ph: (816) 886-2184 |
| NPI Number | 1376757617 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 03/21/2014 |
| Medicare PECOS PAC ID | 4284865056 |
|---|---|
| Medicare Enrollment ID | O20140319001260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376757617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | RICIO (Missouri) | Primary |
| Provider Name | Nabil A El Halawany |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790761260 PECOS PAC ID: 3577523489 Enrollment ID: I20041014001130 |
| Provider Name | Michael G Maurizi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235252453 PECOS PAC ID: 1052360377 Enrollment ID: I20050113000632 |
| Provider Name | Suzanne King |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760469977 PECOS PAC ID: 7416906748 Enrollment ID: I20050113000699 |
| Provider Name | Marguerite Devonne French |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871525162 PECOS PAC ID: 8426081829 Enrollment ID: I20050915001031 |
| Provider Name | Mohammed A Mirza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710067822 PECOS PAC ID: 4789699695 Enrollment ID: I20060214000557 |
| Provider Name | Casey Scott Prough |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396723706 PECOS PAC ID: 5991710782 Enrollment ID: I20060215000599 |
| Provider Name | Elaine T. Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386833788 PECOS PAC ID: 7113090838 Enrollment ID: I20080725000713 |
| Provider Name | Shubha Raja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336355585 PECOS PAC ID: 0547491185 Enrollment ID: I20140325001934 |
| Provider Name | Jennifer A Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548659675 PECOS PAC ID: 1355667734 Enrollment ID: I20150302001081 |
| Provider Name | Debra L Olson-morrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326362369 PECOS PAC ID: 8224354246 Enrollment ID: I20150309002600 |
| Provider Name | Anthony C Morrison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245299056 PECOS PAC ID: 4284538612 Enrollment ID: I20150310000990 |
| Provider Name | Michael E Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295706430 PECOS PAC ID: 5294973756 Enrollment ID: I20160720002593 |
| Provider Name | Doneva J Snow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649979147 PECOS PAC ID: 8729453618 Enrollment ID: I20230406000767 |
| Provider Name | Christopher Moon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376608190 PECOS PAC ID: 6406296078 Enrollment ID: I20240430001009 |
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