Provider Demographics
NPI:1821501230
Name:DONALD RESPESS, PSYD, LLC
Entity Type:Organization
Organization Name:DONALD RESPESS, PSYD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:RESPESS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:314-833-8855
Mailing Address - Street 1:10411 CLAYTON RD STE 209
Mailing Address - Street 2:
Mailing Address - City:FRONTENAC
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2912
Mailing Address - Country:US
Mailing Address - Phone:314-833-8855
Mailing Address - Fax:
Practice Address - Street 1:10411 CLAYTON RD STE 209
Practice Address - Street 2:
Practice Address - City:FRONTENAC
Practice Address - State:MO
Practice Address - Zip Code:63131-2912
Practice Address - Country:US
Practice Address - Phone:314-833-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009027726261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health