Healthcare Provider Details

I. General information

NPI: 1275634644
Provider Name (Legal Business Name): APPLIED PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 W 26TH ST
JOPLIN MO
64804-0398
US

IV. Provider business mailing address

1627 W 26TH ST
JOPLIN MO
64804-0398
US

V. Phone/Fax

Practice location:
  • Phone: 417-627-9601
  • Fax: 417-627-9032
Mailing address:
  • Phone: 417-627-9601
  • Fax: 417-627-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MINDY J MILLER
Title or Position: OWNER/PRESIDENT
Credential: LCSW
Phone: 417-627-9601