Phoenix Psychological Group, Inc

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

PY01201 Issued in MO

Legal business name

PHOENIX PSYCHOLOGICAL GROUP, INC

Practice address

225 S Meramec Ave
Suite 506
Saint Louis, MO 63105-3596

Phone

(314) 863-3588

Fax

(314) 863-0074

NPI assigned

Apr 9, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patricia S Shaw, PHDNPI 1245254317

Title

President

Phone

(314) 863-3588

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Shaw, PHD

  • Psychologist
  • Saint Louis, MO
  • NPI 1245254317
  Authorized official Same address or phone
• Jerry C Clerc, MED LPC

  • Mental Health Counselor
  • Clayton, MO
  • NPI 1366503740
  NPD (past)
• Paul H. Wang, PH.D.

  • Clinical Psychologist
  • Saint Louis, MO
  • NPI 1396769295
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386767994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "SUITE 506",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053596",
            "telephone_number": "314-863-3588",
            "fax_number": "314-863-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S MERAMEC AVE",
            "address_2": "SUITE 506",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631053596",
            "telephone_number": "314-863-3588",
            "fax_number": "314-863-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PSYCHOLOGICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-863-3588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "MO",
            "license": "PY01201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493257802",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-PATRICIA SHAW",
            "identifier": "1245254317",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Phiri
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• Phoenix Behavioral Health
• Phoenix Home Care, LLC
• Phoenix Home Care, LLC (Phoenix Home Care and Hospice)
• Erin Buckley Phoenix, LPC
• Andrew Phung
• Physical and Sports Therapy Services of St Louis
• Physical Therapy Collective, LLC
• Physical Therapy Consultants, Inc

• Prescribing (Medical) Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Prescribing (Medical) Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.