Organization
PSYCARE OF CALLAWAY COUNTY, LLC
Active
Other names
Psycare
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH DEBRODIE LCSW (CEO)
(573) 220-8366
Entity
Organization
Contact information
Practice address
601 W NIFONG, BLDG. 5A, COLUMBIA, MO 65203
(573) 220-2366
Mailing address
PO BOX 605, FULTON, MO 65251-0605
(573) 642-0087
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2003018483
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498394212
—
MO
Enumeration date
04/24/2007
Last updated
09/14/2023
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