Provider Demographics
NPI:1164465233
Name:LANDSBERG PSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:LANDSBERG PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:LANDSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:816-373-7878
Mailing Address - Street 1:4201 S. HOCKER DR.
Mailing Address - Street 2:STE. B2
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-4723
Mailing Address - Country:US
Mailing Address - Phone:816-373-7878
Mailing Address - Fax:816-373-7621
Practice Address - Street 1:4201 S. HOCKER DR.
Practice Address - Street 2:STE. B2
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4723
Practice Address - Country:US
Practice Address - Phone:816-373-7878
Practice Address - Fax:816-373-7621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00375103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4343682OtherMAGELLAN
MO100719OtherMHN
MO613317OtherKANSAS BLUE CROSS
MOS59878OtherVALUE OPTIONS
MO07185-014OtherBLUECROSS/BLUESHIELD #
MO6143117OtherUBH
MOS59878OtherVALUE OPTIONS
MO4343682OtherMAGELLAN