St. Louis Behavioral Associates LTD.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

01628 Issued in MO

Legal business name

ST. LOUIS BEHAVIORAL ASSOCIATES LTD.

Practice address

745 Craig Rd
Suite 210
Saint Louis, MO 63141-7160

Phone

(314) 997-1183

Fax

(314) 997-1196

NPI assigned

Oct 9, 2007

Last updated

May 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Anne Moergen, PH.D.

Title

President/Owner

Phone

(314) 997-1183

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Jennifer SW Gafford, PHD

  • Clinical Child & Adolescent Psychologist
  • Saint Louis, MO
  • NPI 1942259809
  NPD (past)
• Mary J Mandello, PHD

  • Psychologist
  • Saint Louis, MO
  • NPI 1922082569
  NPD (past)

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272844800000",
    "number": "1972791531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 CRAIG RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417160",
            "telephone_number": "314-997-1183",
            "fax_number": "314-997-1196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 CRAIG RD",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417160",
            "telephone_number": "314-997-1183",
            "fax_number": "314-997-1196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS BEHAVIORAL ASSOCIATES LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2010-05-03",
        "status": "A",
        "authorized_official_last_name": "MOERGEN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "314-997-1183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MO",
            "license": "01628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29171",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; 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.