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General NPI Number Information
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NPI Number | 1912250721
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Entity Type | Organization
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Legal Business Name | MERCY BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 1000 DES PERES RD SUITE 200-C
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2050
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Country | US
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Telephone | 314-729-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 DES PERES RD SUITE 200-C
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2050
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CARRIE C. HARRISON
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Credential |
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Telephone | 314-729-4667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 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 #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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