Provider Demographics
NPI:1598062200
Name:DENNIS INSTITUTE FOR EATING DISORDERS PSYCHOTHERAPY, INC.
Entity Type:Organization
Organization Name:DENNIS INSTITUTE FOR EATING DISORDERS PSYCHOTHERAPY, INC.
Other - Org Name:DENNIS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:314-862-5151
Mailing Address - Street 1:141 N MERAMEC AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-862-5151
Mailing Address - Fax:
Practice Address - Street 1:141 N MERAMEC AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3750
Practice Address - Country:US
Practice Address - Phone:314-862-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOSW0003031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty