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1144205527

NPI Code Detail

MEDICARE: ALLIED MENTAL HEALTH ASSOCIATES, INC.

MEDICARE: ALLIED MENTAL HEALTH ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2003032134	MO
2	101YP2500X	Professional Counselor	2004037106	MO
3	101YP2500X	Professional Counselor	2004037100	MO
4	101YP2500X	Professional Counselor	2001029222	MO
5	101YP2500X	Professional Counselor	2000151808	MO
6	103TC0700X	Clinical Psychologist	2001014377	MO
7	103TC0700X	Clinical Psychologist	2000159804	MO
8	103TC0700X	Clinical Psychologist	01503	MO
9	103TC0700X	Clinical Psychologist	2004013232	MO
10	1041C0700X	Clinical Social Worker	000440	MO
11	1041C0700X	Clinical Social Worker	000619	MO
12	1041C0700X	Clinical Social Worker	000534	MO
13	1041C0700X	Clinical Social Worker	000728	MO
14	101YP2500X	Professional Counselor	2000175971	MO
15	101YP2500X	Professional Counselor		MO

General Provider Information

NPI Number	:	1144205527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED MENTAL HEALTH ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	100 S PREWITT ST
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-1760
Country	:	US
Telephone Number	:	417-667-8700
Fax Number	:	417-667-7382

Provider Business Practice Location Address
First Line	:	100 S PREWITT ST
Second Line	:
City	:	NEVADA
State	:	MO
Zip	:	64772-1760
Country	:	US
Telephone Number	:	417-667-8700
Fax Number	:	417-667-7382

Authorized Official
Title or Position	:	CO-OWNER
Name	:	HARLEY V GULLETT
Credential	:	ACSW, LCSW
Telephone Number	:	417-667-8700

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	02/19/2008

Similar Medicare Providers

1659217891 — TARA BAKER
Practice Location Address:

100 S PREWITT ST
NEVADA, MO
64772-1760

Practice Phone: 816-417-2832
Practice Fax:

1295719615 — MRS. NATASHIA SYMES LPC, RPT
Practice Location Address:

100 S PREWITT ST
NEVADA, MO
64772-1760

Practice Phone: 417-667-8700
Practice Fax: 417-667-7382

1508840927 — MRS. SUSAN TUCK LPC
Practice Location Address:

100 S PREWITT ST
NEVADA, MO
64772-1760

Practice Phone: 417-667-8700
Practice Fax: 417-667-7382

1265416770 — MR. HARLEY V GULLETT ACSW, LCSW
Practice Location Address:

100 S PREWITT ST
NEVADA, MO
64772-1760

Practice Phone: 417-667-8700
Practice Fax: 417-667-7382

1821072349 — MR. DAVID L NEIDEL LCSW
Practice Location Address:

100 S PREWITT ST
NEVADA, MO
64772-1760

Practice Phone: 417-667-8700
Practice Fax: 417-667-7382

1811971336 — DR. RANDY V NOBLE PSY.D.
Practice Location Address:

100 S PREWITT ST
NEVADA, MO
64772-1760

Practice Phone: 417-667-8700
Practice Fax: 417-667-7382

Directions to “ALLIED MENTAL HEALTH ASSOCIATES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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