Organization
State of Missouri
Provider's NPPES record last updated: October 27, 2020
Overview
- Entity Type
- Organization
- NPI
- 1578199238
- Primary Specialty
- Psychologist — Rehabilitation
- Practice Location
- Jefferson City, Missouri
- Organization Subpart
- Yes
- Parent Organization
- State of Missouri
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 3:32 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Psychologist
Rehabilitation
Behavioral Health & Social Service Providers
A psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illness. Rehabilitation psychologists, often within teams, assess and treat cognitive, emotional, and functional difficulties, and help people to overcome barriers to participation in life activities. Rehabilitation psychologists are involved in practice, research, and advocacy, with the broad goal of fostering independence and opportunity for people with disabilities.
Taxonomy code 103TR0400X
Practice Locations
Practice Location
1706 E Elm St
Jefferson City, Missouri 65101-4130
Phone: (573) 751-3398
Other Names
- Cpr YouthReported March 12, 2020
- Cpr YouthReported October 27, 2020
Record Information
- Enumeration Date
- March 13, 2020
- Provider's NPPES Record Last Updated
- October 27, 2020
- Certification Date
- October 27, 2020
- NPISignal NPPES Dataset
- August 2026
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