Van Pelt, David Michael

Van Pelt, David Michael is an sole proprietor health care provider with primary practice located at 903 S Kingshighway St , Sikeston MO 63801-4415. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Van Pelt, David Michael can be contacted via phone (573) 472-2139.

Contact Information

Primary practice address
903 S Kingshighway St Sikeston MO 63801-4415
Phone: (573) 472-2139
Fax: (573) 472-6457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X MO2005015544 Missouri

Profile Details

NPI number 1821066242
LBN Legal business name Van Pelt, David Michael
Credentials PSY.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 10th, 2006
Last updated Feb 28th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821066242 NPPES
Missouri Other SDA3992113 CHILD TREATMENT SERVICES
Missouri MEDICAID 499322014 CHILD TREATMENT SERVICES

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