Healthcare Provider Details
I. General information
NPI: 1336068642
Provider Name (Legal Business Name): OZARK CREST PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
231 S BEMISTON AVE
CLAYTON MO
63105-1988
US
IV. Provider business mailing address
3159 CARPENTERS PARK RD
DAVIDSVILLE PA
15928-9223
US
V. Phone/Fax
- Phone: 888-281-7969
- Fax:
- Phone: 888-281-7969
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
GRIESHEIMER
Title or Position: CEO
Credential:
Phone: 814-243-0414