Healthcare Provider Details

I. General information

NPI: 1629994892
Provider Name (Legal Business Name): PSYCONNECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 PARK ST APT 12
PARK HILLS MO
63601-4459
US

IV. Provider business mailing address

512 PARK ST APT 12
PARK HILLS MO
63601-4459
US

V. Phone/Fax

Practice location:
  • Phone: 314-332-4090
  • Fax: 314-332-4090
Mailing address:
  • Phone: 314-332-4090
  • Fax: 314-332-4090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENIFER CHRISTINE BARNES
Title or Position: THERAPIST
Credential: LPC
Phone: 314-332-4090