Geriatric Psychotherapy Services Gina Bax, MSW, LCSW, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GERIATRIC PSYCHOTHERAPY SERVICES GINA BAX, MSW, LCSW, LLC

Practice address

261 Bless US Dr E
Wentzville, MO 63385-2227

Phone

(636) 577-4607

NPI assigned

May 10, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Gina Nicole Bax, LCSW

Title

Clinical Social Worker

Phone

(636) 577-4607

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1497047450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 BLESS US DR E",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633852227",
            "telephone_number": "636-577-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 BLESS US DR E",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633852227",
            "telephone_number": "636-577-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PSYCHOTHERAPY SERVICES GINA BAX, MSW, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "BAX",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "636-577-4607",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Community/Behavioral Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.