Provider Demographics
NPI:1932377496
Name:MERCY NEUROPSYCHOLOGY SERVICES, LLC
Entity type:Organization
Organization Name:MERCY NEUROPSYCHOLOGY SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR - FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-364-3707
Mailing Address - Street 1:615 S NEW BALLAS RD
Mailing Address - Street 2:NEUROPSYCHOLOGY - GROUND FLOOR
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8221
Mailing Address - Country:US
Mailing Address - Phone:314-251-4683
Mailing Address - Fax:314-251-4380
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:NEUROPSYCHOLOGY - GROUND FLOOR
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-4683
Practice Address - Fax:314-251-4380
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY HOSPITALS EAST COMMUNITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-18
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO509008009Medicaid