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General NPI Number Information
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NPI Number | 1245774348
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Entity Type | Organization
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Legal Business Name | MISSOURI BEHAVIORAL HEALTH COUNSELING ASSOCIATES
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Dates
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Enumeration Date | 12/07/2016
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 104 CRESCENT DR
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City | LEBANON
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State | MO
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Zip | 65536-3301
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Country | US
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Telephone | 417-664-4584
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Fax | 417-588-4296
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Provider Business Mailing Address
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Address Line | 104 CRESCENT DR
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City | LEBANON
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State | MO
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Zip | 65536-3301
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Country | US
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Telephone | 417-588-5885
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Fax | 417-588-4296
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | SHEILA JEAN BUIE
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Credential |
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Telephone | 417-588-5885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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