Healthcare Provider Details
I. General information
NPI: 1285126847
Provider Name (Legal Business Name): ANXIETY & DEPRESSION CLINIC OF COLUMBIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/30/2018
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2600 FORUM BLVD STE G
COLUMBIA MO
65203-6343
US
IV. Provider business mailing address
2600 FORUM BLVD STE G
COLUMBIA MO
65203-6343
US
V. Phone/Fax
- Phone: 573-239-9915
- Fax: 573-340-1028
- Phone: 573-239-9915
- Fax: 573-340-1028
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 2010042076 |
| License Number State | MO |
VIII. Authorized Official
Name:
JARED
B
TORBET
Title or Position: OWNER / CLINICAL DIRECTOR
Credential: LPC
Phone: 573-239-9915