Provider Demographics
NPI:1891821120
Name:COMPREHENSIVE PSYCHIATRIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE PSYCHIATRIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNGHANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-455-0556
Mailing Address - Street 1:305 NW ENGLEWOOD CT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4072
Mailing Address - Country:US
Mailing Address - Phone:816-453-7473
Mailing Address - Fax:816-453-1940
Practice Address - Street 1:305 NW ENGLEWOOD CT
Practice Address - Street 2:SUITE 300
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-4072
Practice Address - Country:US
Practice Address - Phone:816-453-7473
Practice Address - Fax:816-453-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1891821120Medicaid
MO24909012OtherBCBS GROUP PHYSICIAN #
MO1891821120Medicaid