Psychotherapy LLC
NPI 1164203188ActiveOrganization· Social Worker, Clinical· Crystal City, MO
Social Worker, Clinical in Crystal City, Missouri, registered in NPPES in October 2023. The authorized official on file is Diana Blackwell, Clinical Social Worker. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1164203188 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 6, 2023 |
| Last updated in NPPES | Jul 3, 2026 |
| Certified by provider | Jul 3, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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