Active NPI
Seth R Allen, EDD, LP
- Clinical Psychologist
- Springfield, MO
National Provider Identifier
1407036254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2007033978
- Practice address
- 1300 E Bradford Pkwy
Springfield, MO 65804-4264 - Phone
- (417) 761-5000
- Fax
- (417) 761-5011
- NPI assigned
- Nov 9, 2007
- Last updated
- Mar 18, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2007033978 | MO | Primary |
Addresses
Primary practice location
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Mailing address
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13759877 | Other | MO | CAQH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007033978 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1407036254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 E BRADFORD PKWY",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044264",
"telephone_number": "417-761-5000",
"fax_number": "417-761-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 E BRADFORD PKWY",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658044264",
"telephone_number": "417-761-5000",
"fax_number": "417-761-5011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "SETH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "EDD, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-09",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2007033978",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13759877",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, MO
- Livia Allen, PHARMD
- Madalyn Allen
- Mercedes Elaine Allen
- Natalie Allen, RD
- Sarah L Allen, BHRS
- Tesia Lashae Allen
- Allergy & Asthma of Springfield, LLC (Allergy and Asthma of Springfield)
- Nathaniel Allgaier
- Allied Physicians Group LLC (Breakthrough Pain Relief Clinic)
- Ethel Marie Allison, RN, MPH, BSN, CDE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.