Provider Demographics
NPI:1578751350
Name:COMPREHENSIVE PSYCHIATRY OF ST. LOUIS,LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHIATRY OF ST. LOUIS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-725-2199
Mailing Address - Street 1:665 S SKINKER BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-2300
Mailing Address - Country:US
Mailing Address - Phone:314-725-2199
Mailing Address - Fax:314-726-9682
Practice Address - Street 1:665 S SKINKER BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-2300
Practice Address - Country:US
Practice Address - Phone:314-725-2199
Practice Address - Fax:314-726-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2084P0800X2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty