Organization Active NPI

Overstreet Psychology Services

  • Clinical Psychologist
  • Florissant, MO
National Provider Identifier
1760668628
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
01765 Issued in MO
Legal business name
OVERSTREET PSYCHOLOGY SERVICES
Practice address
1150 Graham Rd
Suite 115
Florissant, MO 63031-8077
Phone
(314) 831-7774
Fax
(314) 831-2775
NPI assigned
Jan 10, 2008
Last updated
Oct 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
Dr. Dave L. Overstreet, PH.D.
Title
Owner
Phone
(314) 831-7774

Specialties & licenses 1

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

Addresses

Primary practice location

1150 Graham Rd
Suite 115
Florissant, MO 63031-8077

Mailing address

1150 Graham Rd
Suite 115
Florissant, MO 63031-8077
Phone (314) 831-7774

Other identifiers 1

IdentifierTypeStateIssuer
990001701OtherMOMEDICARE GROUP

National Provider Directory

National Provider Directory

Locations

1150 Graham Rd
Ste 115
Florissant, MO 63031
Phone (314) 831-7774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1760668628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD",
            "address_2": "SUITE 115",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "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": "1150 GRAHAM RD",
            "address_2": "SUITE 115",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-831-7774",
            "fax_number": "314-831-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERSTREET PSYCHOLOGY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "OVERSTREET",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-831-7774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "01765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "990001701",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.