NPIMap

Organization Active NPI

Southeast Missouri Community Treatment Center, Inc.

  • Clinical Social Worker
  • Poplar Bluff, MO
National Provider Identifier
1689690984
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2004035019 Issued in MO
Legal business name
SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER, INC.
Practice address
101 S Main St
Poplar Bluff, MO 63901-5843
Phone
(573) 686-5090
Fax
(573) 518-0329
NPI assigned
Jul 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Janet Sue McLane-Li, LCSW
Title
LCSW
Phone
(573) 686-5090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 2004035019 MO Primary

Addresses

Primary practice location

101 S Main St
Poplar Bluff, MO 63901-5843

Mailing address

PO Box 506
Park Hills, MO 63601-0506
Phone (573) 431-0554

Other names 1

  • same Other name

National Provider Directory

National Provider Directory
Tax ID family
Southeast Missouri Behavioral Health15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689690984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 506",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636010506",
            "telephone_number": "573-431-0554",
            "fax_number": "573-518-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015843",
            "telephone_number": "573-686-5090",
            "fax_number": "573-518-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MISSOURI COMMUNITY TREATMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCLANE-LI",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "573-686-5090",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004035019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "same",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • 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.