Eileen Bartow-Rives, PHD, LP

Individual provider Active NPI Clinical Psychologist · Springfield, MO

NPI 1669478608 · NPPES record last updated May 13, 2019

Key facts

NPI
1669478608
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
00988 (MO)
Practice address
1350 E Bradford Pkwy
Springfield, MO 65804-4376
Phone
(417) 761-5850
Fax
(417) 761-5851
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00988MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00988 MO Yes

Addresses

Primary practice location

1350 E Bradford Pkwy
Springfield, MO 65804-4376

Mailing address

1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 269-5400

Other identifiers

IdentifierTypeStateIssuer
493253736MedicaidMO

Other providers in Springfield, MO

All providers in Springfield, MO · Clinical Psychologist in Missouri

Sources for this page

Verify at the official NPI Registry.