Provider Demographics
NPI:1447425483
Name:UNIVERSITY PSYCHIATRIC ASSOCIATES,LLC
Entity Type:Organization
Organization Name:UNIVERSITY PSYCHIATRIC ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-872-6808
Mailing Address - Street 1:443 N NEW BALLAS RD STE 249
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6866
Mailing Address - Country:US
Mailing Address - Phone:314-872-6808
Mailing Address - Fax:314-872-9103
Practice Address - Street 1:443 N NEW BALLAS RD STE 249
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6866
Practice Address - Country:US
Practice Address - Phone:314-872-6808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20010245782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty