Provider Demographics
NPI:1174950521
Name:BABBITT MEDIATION & GERIATRIC SERVICES, LLC
Entity type:Organization
Organization Name:BABBITT MEDIATION & GERIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:RICHELE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BABBITT
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:417-434-3399
Mailing Address - Street 1:8687 STATE HIGHWAY 43
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-9161
Mailing Address - Country:US
Mailing Address - Phone:417-434-3399
Mailing Address - Fax:
Practice Address - Street 1:8687 STATE HIGHWAY 43
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-9161
Practice Address - Country:US
Practice Address - Phone:417-434-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20110169501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty