Stacy Barham
Individual provider Active NPI Clinical Psychologist · Mansfield, MO
NPI 1821374935 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1821374935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2014008375 (MO)
- Practice address
- 827 W Commercial St
Mansfield, MO 65704-9520 - Phone
- (417) 924-8188
- NPI assigned
- Nov 2, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Greater Ozarks Rural Psychologists LLC
Practice addresses (Care Compare)
827 W Commercial St
Mansfield, MO 65704-9520
Phone (417) 924-8188
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 |
|---|---|---|---|---|
| I20150922001059 | MO | Practitioner - Clinical Psychologist | 9032426168 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011036261 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Ozarks Rural Psychologists LLC | Clinical | Current |
Accepting new patients |
Locations
827 W Commercial St
Mansfield, MO 65704
Phone (417) 924-8188
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2011036261 | MO | |
| Clinical Psychologist | 103TC0700X | 2014008375 | MO | Yes |
Addresses
Primary practice location
827 W Commercial St
Mansfield, MO 65704-9520
Mailing address
827 W Commercial St
Mansfield, MO 65704-9520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821374935 | Medicaid | MO |
Other providers in Mansfield, MO
- Artisan Helping Hands Inc
- Amy Parmenter Barber
- Micah Danielle Barton
- Kathy Bell X
- Robert Christian Doneski
- Douglas County Public Health Services Group, Inc.
- Douglas County Public Health Services Group, Inc.
All providers in Mansfield, 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 Mar 19, 2014. 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.