Synergy Executive, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SYNERGY EXECUTIVE, LLC

Practice address

2608 Smyrna Rd
Ozark, MO 65721-7674

Phone

(417) 812-4440

Fax

(417) 208-5880

NPI assigned

Jan 29, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Paige Tuck, LPC

Title

Executive Director

Phone

(417) 551-9192

Specialties & licenses 2

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew Everett White, LCSW

  • Clinical Social Worker
  • Ozark, MO
  • NPI 1891431037
  NPD
• Codie Jordan Vassar, M.D

  • Psychiatry Physician
  • Kenosha, WI
  • NPI 1538690995
  NPD (past)

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1639633290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 SMYRNA ROAD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "telephone_number": "417-838-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 SMYRNA RD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657217674",
            "telephone_number": "417-812-4440",
            "fax_number": "417-208-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY EXECUTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "TUCK",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "417-551-9192",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF MENTAL HEALTH/DBH",
            "identifier": "2849",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jo Ellen Betty Strode, MS, PLPC, NCC
• Strong Tower Counseling LLC
• David Allen Struble, D.D.S.
• Michael Cody Swearengin, MA, LPC
• George Sweidan
• Huma Tariq, MD
• Marsha A Taylor, MD
• William E Taylor, PHARM D
• Brian H Teeter, MD
• Bernard Raymond Tellez, DDS

• Substance Abuse Rehabilitation Facility in Ozark, MO
• Providers in Ozark, MO by specialty
• Substance Abuse Rehabilitation Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.