Healthcare Provider Details

I. General information

NPI: 1679618052
Provider Name (Legal Business Name): OZARK PSYCHOLOGICAL ASSOCIATES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 E SUNSHINE ST SUITE 811
SPRINGFIELD MO
65804-1343
US

IV. Provider business mailing address

1736 E SUNSHINE ST SUITE 811
SPRINGFIELD MO
65804-1343
US

V. Phone/Fax

Practice location:
  • Phone: 417-882-4485
  • Fax: 417-882-5517
Mailing address:
  • Phone: 417-882-4485
  • Fax: 417-882-5517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANE A. DOSCH
Title or Position: ADMINISTRATOR
Credential: LPC
Phone: 417-882-4485