Provider Demographics
NPI:1891565180
Name:DSM PSYCHIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:DSM PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:SHANE
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:573-664-1047
Mailing Address - Street 1:203 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-1836
Mailing Address - Country:US
Mailing Address - Phone:573-664-1047
Mailing Address - Fax:573-218-0716
Practice Address - Street 1:203 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1836
Practice Address - Country:US
Practice Address - Phone:573-664-1047
Practice Address - Fax:573-218-0716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty