Healthcare Provider Details

I. General information

NPI: 1275233231
Provider Name (Legal Business Name): SINAPSIS PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 CREEKSIDE OFFICE DR
WENTZVILLE MO
63385-3290
US

IV. Provider business mailing address

207 CREEKSIDE OFFICE DR
WENTZVILLE MO
63385-3290
US

V. Phone/Fax

Practice location:
  • Phone: 636-887-0914
  • Fax: 636-206-2522
Mailing address:
  • Phone: 636-887-0914
  • Fax: 636-206-2522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: FERNANDO PEREZ-MAGNELLI
Title or Position: MD
Credential: MD
Phone: 636-887-0914