Organization
PSYCARE OF CALLAWAY COUNTY, LLC
Active
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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