Individual provider Active NPI

David L Overstreet, PH D

  • Clinical Psychologist
  • Florissant, MO
National Provider Identifier
1710040902
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
01765 Issued in MO
Practice address
1281 Graham Rd
Suite 305
Florissant, MO 63031-8029
Phone
(314) 831-7774
Fax
(314) 831-2775
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 01765 MO Primary

Addresses

Primary practice location

1281 Graham Rd
Suite 305
Florissant, MO 63031-8029

Mailing address

1281 Graham Rd
Suite 305
Florissant, MO 63031-8029
Phone (314) 831-7774

Other identifiers 1

IdentifierTypeStateIssuer
496832528MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Network, Inc. CurrentSince Mar 1, 2020 Accepting new patients
David a. Lipsitz, PH.D., Inc Clinical CurrentSince Mar 1, 2020 Accepting new patients

Locations

58 Portwest Ct
Saint Charles, MO 63303
Phone (636) 916-5800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1710040902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 GRAHAM RD",
            "address_2": "SUITE 305",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318029",
            "telephone_number": "314-831-7774",
            "fax_number": "314-831-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 GRAHAM RD",
            "address_2": "SUITE 305",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318029",
            "telephone_number": "314-831-7774",
            "fax_number": "314-831-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "01765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "496832528",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.