Kimberly Brooke Conde, PSY.D.
Individual provider Active NPI Clinical Psychologist · Camdenton, MO
NPI 1770104044 · NPPES record last updated Apr 28, 2020
Key facts
- NPI
- 1770104044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2016005652 (MO)
- Practice address
- 89 McCrory Drive
Camdenton, MO 65020 - Phone
- (573) 433-2833
- NPI assigned
- Apr 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lake Behavioral Health
Practice addresses (Care Compare)
5529 B Osage Beach Pkwy
Osage Beach, MO 65065-3023
Phone (573) 693-9090
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200803001667 | MO | Practitioner - Clinical Psychologist | 5890110241 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016005652 | MO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Behavioral Health Associates, LLC | Clinical | Current |
Accepting new patients |
| Lake Behavioral Health | Current |
Accepting new patients | |
| Benton Street Counseling LLC | Past |
Accepting new patients |
Locations
5529B Osage Beach Pkwy
Osage Beach, MO 65065
Phone (573) 693-9090
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2016005652 | MO | Yes |
Addresses
Primary practice location
89 McCrory Drive
Camdenton, MO 65020
Mailing address
416 N Village Cir
Columbia, MO 65203-5666
Phone (573) 356-1134
Other providers in Camdenton, MO
- Nichole Choate
- Chris Franklin DO PC
- Alex Clarke
- Paul H Compney
- Gail Compton
- Evan K Connell
- Matthew Evan Connell
- Christine Cooper
- County of Camden
- Dillon Companies LLC
All providers in Camdenton, MO · Clinical Psychologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.