Healthcare Provider Details

I. General information

NPI: 1821501230
Provider Name (Legal Business Name): DONALD RESPESS, PSYD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 12/16/2022
Certification Date: 12/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10411 CLAYTON RD STE 209
FRONTENAC MO
63131-2912
US

IV. Provider business mailing address

10411 CLAYTON RD STE 209
FRONTENAC MO
63131-2912
US

V. Phone/Fax

Practice location:
  • Phone: 314-833-8855
  • Fax:
Mailing address:
  • Phone: 314-833-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number2009027726
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number2009027726
License Number StateMO

VIII. Authorized Official

Name: DR. DONALD RESPESS
Title or Position: PRESIDENT
Credential: PSYD
Phone: 314-833-8855