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General NPI Number Information
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NPI Number | 1407993744
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Entity Type | Organization
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Legal Business Name | COUNSELING & PSYCHOLOGICAL SERVICES, UNIVERSITY OF CENTRAL MISSOURI
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | HUMPHREYS BLDG STE131 UNIVERSITY OF CENTRAL MISSOURI
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City | WARRENSBURG
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State | MO
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Zip | 64093-5176
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Country | US
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Telephone | 660-543-4060
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Fax | 660-543-8277
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Provider Business Mailing Address
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Address Line | HUMPHREYS BLDG STE131 UNIVERSITY OF CENTRAL MISSOURI
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City | WARRENSBURG
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State | MO
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Zip | 64093-5176
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Country | US
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Telephone | 660-543-4060
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Fax | 660-543-8277
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR OF UHS FOR CPS
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Name | DR. PAUL DALLAS POLYCHRONIS
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Credential | PH.D.
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Telephone | 660-543-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY01533
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License Number State | MO
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