Organization · Type 2 NPI

State of Missouri

Psychiatry Physician · St. Louis, MO

NPI number 1376753798 Active

Practice location

1901 Pennsylvania Ave
St. Louis, MO 63133-1325

Call (314) 512-7800 Map

Mailing address

1706 E Elm St
Jefferson City, MO 65101-4130

Specialties and licenses

Taxonomy	Code	License
Psychologist	103T00000X	None listed
Clinical Social Worker	1041C0700X	None listed
Psychiatry Physician Primary	2084P0800X	None listed

Psychiatry Physician: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic la…

14 other providers at this address

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NPI record

NPI: 1376753798
Entity type: Organization (Type 2)
Issued: May 23, 2007
Last updated: Oct 27, 2020
Status: Active
Subpart: Yes of State of Missouri

Other names

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Hawthorn Children's Psychiatric Hosptial · doing business as
Hawthorn Children's Psychiatric Hosptial · doing business as

Authorized official

Molly Jane Boeckmann
Director of Administrative Services
(573) 751-4055

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376753798

State of Missouri's National Provider Identifier is 1376753798, issued on May 23, 2007. The primary taxonomy on file is Psychiatry Physician (2084P0800X), and the practice location is in St. Louis, MO. The record was last updated on Oct 27, 2020.