Organization Active NPI

Midwest Behavioral Health, LLC

  • Case Management Agency
  • Troy, MO
National Provider Identifier
1700820099
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
MIDWEST BEHAVIORAL HEALTH, LLC
Practice address
116 S Lincoln Dr
Troy, MO 63379-1418
Phone
(636) 528-1996
Fax
(636) 528-1833
NPI assigned
Jun 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Carl Davis Jr., PSY.D.NPI 1366468126
Title
Owner
Phone
(660) 281-6601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

116 S Lincoln Dr
Troy, MO 63379-1418

Mailing address

116 S Lincoln Dr
Troy, MO 63379-1418
Phone (636) 528-1996

Other identifiers 1

IdentifierTypeStateIssuer
504578303MedicaidMO

National Provider Directory

National Provider Directory

Locations

3143 Highway 61
Hannibal, MO 63401
Phone (573) 221-8266

109 E Lafayette St
Monticello, MO 63457
Phone (573) 767-5436

116 S Lincoln Dr
Troy, MO 63379
Phone (636) 528-1996

395 Travis Blvd
Troy, MO 63379
Phone (636) 528-1996

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1700820099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S LINCOLN DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791418",
            "telephone_number": "636-528-1996",
            "fax_number": "636-528-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S LINCOLN DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791418",
            "telephone_number": "636-528-1996",
            "fax_number": "636-528-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "660-281-6601",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504578303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.