Active NPI
Noble Health Audrain Inc
- Clinical Psychologist
- Mexico, MO
National Provider Identifier
1104404714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- NOBLE HEALTH AUDRAIN INC
- Practice address
- 620 E Monroe St
Mexico, MO 65265-2919 - Phone
- (573) 582-5000
- Fax
- (573) 582-3700
- NPI assigned
- Apr 2, 2021
- Organization subpart
- Yes
- Parent organization
- NOBLE HEALTH AUDRAIN INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy L Obrien
- Title
- Ceo
- Phone
- (573) 582-5000
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Clinical Psychologist | 103TC0700X | Primary | ||
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
620 E Monroe St
Mexico, MO 65265-2919
Mailing address
620 E Monroe St
Mexico, MO 65265-2919
Phone (573) 582-5000
Other names 2
- Platinum Health Systems Audrain
- Behavioral Health Group
National Provider Directory
National Provider Directory- Part of
- Audrain Comm Cancer Center
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- General Acute Care Hospital
- Mexico, MO
- NPI 1891386504
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655942400000",
"number": "1104404714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 E MONROE ST",
"city": "MEXICO",
"state": "MO",
"postal_code": "652652919",
"telephone_number": "573-582-5000",
"fax_number": "573-582-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 E MONROE ST",
"city": "MEXICO",
"state": "MO",
"postal_code": "652652919",
"telephone_number": "573-582-5000",
"fax_number": "573-582-3700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOBLE HEALTH AUDRAIN INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NOBLE HEALTH AUDRAIN INC",
"enumeration_date": "2021-04-02",
"last_updated": "2022-06-23",
"certification_date": "2022-06-23",
"status": "A",
"authorized_official_last_name": "OBRIEN",
"authorized_official_first_name": "AMY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "573-582-5000"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Platinum Health Systems Audrain",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Behavioral Health Group",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Behavioral Health Group",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Mexico, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.