Jerry Scott Eames, MAC CASAC ICAADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Moberly, MO
NPI 1033304019 · NPPES record last updated Sep 12, 2007
Key facts
- NPI
- 1033304019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 542 (MO)
- Practice address
- 501 N Ault St
Moberly, MO 65270-2506 - Phone
- (660) 263-7552
- Fax
- (660) 263-6593
- NPI assigned
- Sep 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 542 | MO | MD | Addiction (Substance Use Disorder) Counselor |
| 32304 | VA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Escape a&D, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 542 | MO | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 32304 | VA |
Addresses
Primary practice location
501 N Ault St
Moberly, MO 65270-2506
Mailing address
501 N Ault St
Moberly, MO 65270-2506
Phone (660) 263-7552
Other providers in Moberly, MO
- Developing Wings Mental Health LLC
- Dialysis Clinic Inc.
- Alexandra Elizabeth Dockins
- Adriana Duran
- E Medical Group of Missouri No 3 LLC
- Elizabeth Anne East
- Janet Marie Eddy
- Anne C. Eisenbeis
- Elite Pain Management, LLC
- Ann Lorene Elliot
All providers in Moberly, MO · Addiction (Substance Use Disorder) Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.