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General NPI Number Information
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NPI Number | 1275533853
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Entity Type | Organization
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Legal Business Name | PSYCH CARE CONSULTANTS LLC
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 5000 CEDAR PLAZA PKWY SUITE 350
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3854
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Country | US
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Telephone | 314-843-4333
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Fax | 314-843-4856
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Provider Business Mailing Address
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Address Line | 5000 CEDAR PLAZA PKWY SUITE 350
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3854
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Country | US
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Telephone | 314-843-4333
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Fax | 314-843-4856
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. IRSHAD KHAN
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Credential |
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Telephone | 314-843-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 00000
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License Number State | MO
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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 | 00000
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 00000
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 00000
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00000
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License Number State | MO
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