Organization
HEARTLAND REGIONAL MEDICAL CENTER
Active
Other names
Counseling Care Mosaic Life Care
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT CARVELL (DIRECTOR, REIMBURSEMENT - ACCOUNTIN)
(816) 273-0473
Entity
Organization
Contact information
Practice address
3620 FREDERICK AVE, SAINT JOSEPH, MO 64506-3016
(816) 271-6573
(816) 271-6572
Mailing address
137 N BELT HWY, SAINT JOSEPH, MO 64506-3491
(816) 271-6573
(816) 271-6572
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
00711
MO
103T00000X
Psychologist
00996
MO
103T00000X
Psychologist
Primary
—
—
104100000X
Social Worker
SW000121
MO
104100000X
Social Worker
SW001949
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001309000
COMMUNITY HEALTH PLAN
MO
01
—
18524038
BLUE CROSS/ BLUE SHIELD
MO
01
—
215265836
UBH
MO
01
—
241020
VALUE OPTIONS
MO
Enumeration date
07/27/2006
Last updated
01/25/2022
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