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NPI Code Detail

MEDICARE: DR. JASON WILLIAM ENGEL PSY.D.

MEDICARE: DR. JASON WILLIAM ENGEL PSY.D.
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
1103TC0700XClinical Psychologist2008009871MO

General Provider Information

NPI Number : 1851385264
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON WILLIAM ENGEL PSY.D.
Provider Business Mailing Address
First Line : PO BOX 4046
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65808-4046
Country : US
Telephone Number : 417-269-5712
Fax Number : 417-269-7567
Provider Business Practice Location Address
First Line : 3800 S NATIONAL AVE STE 770
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5283
Country : US
Telephone Number : 417-269-6891
Fax Number : 417-269-5595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 09/26/2019

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