Healthcare Provider Details

I. General information

NPI: 1285548164
Provider Name (Legal Business Name): HEART PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 CHESTERFIELD PKWY W STE 260
CHESTERFIELD MO
63017-4836
US

IV. Provider business mailing address

16100 CHESTERFIELD PKWY W STE 260
CHESTERFIELD MO
63017-4836
US

V. Phone/Fax

Practice location:
  • Phone: 636-778-9415
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANA LOUISE VANDERKOOI
Title or Position: NP
Credential: NP
Phone: 314-422-3596