Applied Psychological Center, LLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Cape Girardeau, MO
NPI 1003018417 · NPPES record last updated Feb 10, 2014
Key facts
- NPI
- 1003018417
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- APPLIED PSYCHOLOGICAL CENTER, LLC
- Practice address
- 2907 Independence St
Suite F
Cape Girardeau, MO 63703-5044 - Phone
- (573) 334-3329
- Fax
- (573) 200-7006
- NPI assigned
- Jun 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. David M Van Pelt, PSY,D
- Title
- Executive Director
- Phone
- (573) 334-3329
Practitioners 1
-
David Michael Van Pelt, PSY.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060221000721 | MO | Part B Supplier - Clinic/Group Practice | 2961418496 |
Receives reassigned benefits from 1 practitioner Practice locations: Cape Girardeau, MO |
National Provider Directory
Locations
2907 Independence St
Ste G
Cape Girardeau, MO 63703
Phone (573) 334-3329
2907 Independence St
Ste F
Cape Girardeau, MO 63703
Phone (573) 334-3329
10763 Highway 39
Ste B
Mount Vernon, MO 65712
430 E Mount Vernon Blvd
Mount Vernon, MO 65712
Phone (417) 461-7400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | MO | Yes |
Addresses
Primary practice location
2907 Independence St
Suite F
Cape Girardeau, MO 63703-5044
Mailing address
2907 Independence St
Suite F
Cape Girardeau, MO 63703-5044
Phone (573) 334-3329
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 506277102 | Medicaid | MO | |
| 001976787 | Other | MO | CHILD TREATMENT SERVICES |
Other providers in Cape Girardeau, MO
- Shahzaib Anwar
- Marc Angelo Apostol
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- Jeffrey P. Appleman
- Kathleen K. Appleman
- Apria Healthcare LLC
- Pamela Michele Arbeiter
- Tiffany Armes
- Sharde Armour-Kumah
- Sara Christine Armour
All providers in Cape Girardeau, MO · Mental Health Clinic/Center (Including Community Mental Health Center) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.