Organization
NORTHWOODS PSYCHIATRIC SERVICES INC
Active
Organization
NORTHWOODS PSYCHIATRIC SERVICES INC
Active
Other names
Pomme de Terre Wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DENESE STRANGE (OFFICE MANAGER)
(417) 326-7272
Entity
Organization
Contact information
Practice address
900 E SAN MARTIN ST, BOLIVAR, MO 65613-2893
(417) 326-7272
(417) 326-2193
Mailing address
PO BOX 49, BOLIVAR, MO 65613-0049
(417) 326-7272
(417) 326-2193
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2003024990
MO
101YP2500X
Professional Counselor
2004008720
MO
103TC0700X
Clinical Psychologist
PY01322
MO
1041C0700X
Clinical Social Worker
2004015488
MO
2084P0800X
Psychiatry Physician
R1J41
MO
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
066643
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505814400
—
MO
05
—
597191808
—
MO
Enumeration date
05/23/2006
Last updated
07/31/2025
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