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Organization

JCMG MENTAL HEALTH CLINIC LLC

Active
Other names
Professional Therapy Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY LEE PATRICK M.D. (PRESIDENT/AUTHORIZED OFFICIAL)
(573) 635-5264
Entity
Organization

Contact information

Practice address
1303 EDGEWOOD DR, JEFFERSON CITY, MO 65109-1943
(573) 634-5400
(573) 636-2639
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103T00000X
Psychologist
Primary
1041C0700X
Clinical Social Worker

Other

Enumeration date
12/26/2006
Last updated
08/30/2023
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