Healthcare Provider Details

I. General information

NPI: 1932377496
Provider Name (Legal Business Name): MERCY NEUROPSYCHOLOGY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2008
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S NEW BALLAS RD NEUROPSYCHOLOGY - GROUND FLOOR
SAINT LOUIS MO
63141-8221
US

IV. Provider business mailing address

615 S NEW BALLAS RD NEUROPSYCHOLOGY - GROUND FLOOR
SAINT LOUIS MO
63141-8221
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-4683
  • Fax: 314-251-4380
Mailing address:
  • Phone: 314-251-4683
  • Fax: 314-251-4380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: KERRY DUNGER
Title or Position: EXECUTIVE DIRECTOR - FINANCE
Credential:
Phone: 314-364-3707