CMS-1500 Box 24J / 33a • NPI
1952137861
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
2084P0800X (CMS 26)
Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)
Box 32 Service Location & ZIP+4
856 WATERBURY FALLS DR STE 102, O FALLON, MO, 63368-2219
✓ 9-Digit EDI 837 ZIP+4 (63368-2219)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1952137861 (PROACTIVE BEHAVIORAL HEALTH SOLUTIONS, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1952137861 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | PROACTIVE BEHAVIORAL HEALTH SOLUTIONS, INC. |
| Plain-English Specialty | Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) NUCC Code: 2084P0800X (Psychiatry & Neurology, Psychiatry) |
| Certifying / Licensing Body | American Board of Psychiatry and Neurology (ABPN) |
| Practice Location Address | 856 WATERBURY FALLS DR STE 102, O FALLON, MO, 63368-2219 |
| Practice Telephone / Fax | Tel: (636) 339-1190 | Fax: (816) 631-0171 |
| Administrative Mailing Address | 6389 HIGHWAY C, PALMYRA, MO, 63461-2044 |
| Enumeration & Last Sync | Enumerated: 2024-09-09 | CMS Record Updated: 2026-03-20 |
| Authorized Official | RYAN MORRIS (President) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (2084P0800X)
What Does Taxonomy Code 2084P0800X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2084P0800X translates to:
"Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (PROACTIVE BEHAVIORAL HEALTH SOLUTIONS, INC.)
Typical CPT / Diagnostic Procedures:- Comprehensive Psychiatric Diagnostic Evaluation (CPT 90792)
- Psychopharmacological Management & Supportive Psychotherapy
- Medication-Assisted Treatment (MAT) for Substance Use Disorders
- SSRIs & SNRIs (Sertraline, Escitalopram, Fluoxetine, Duloxetine)
- Bupropion, Mirtazapine & Atypical Antipsychotics (Aripiprazole, Quetiapine)
- Buprenorphine/Naloxone & Naltrexone (Addiction Recovery)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
261QM0850X — Clinic/Center, Adult Mental HealthPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: N/A | License: Verified | Primary: Secondary |
101YP2500X — Counselor, ProfessionalPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Counselor | State: N/A | License: Verified | Primary: Secondary |
2084P0805X — Plain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: N/A | License: Verified | Primary: Secondary |
261QM0855X — Clinic/Center, Adolescent and Children Mental HealthPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Secondary |
2084P0800X — Psychiatry & Neurology, PsychiatryPlain English: Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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