Active NPI
Elma Katherine McBroom, LPC
- Professional Counselor
- Blackwell, MO
National Provider Identifier
1003107236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2010033339
- Practice address
- 10213 Northwood Dr
Blackwell, MO 63626-9521 - Phone
- (573) 202-9790
- NPI assigned
- Apr 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2010033339 | MO | Primary |
Addresses
Primary practice location
10213 Northwood Dr
Blackwell, MO 63626-9521
Mailing address
10213 Northwood Dr
Blackwell, MO 63626-9521
Phone (573) 202-9790
Other names 1
- Elma Katherine Hall
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010033339 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| About Face Counseling, LLC | Professional | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1003107236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10213 NORTHWOOD DR",
"city": "BLACKWELL",
"state": "MO",
"postal_code": "636269521",
"telephone_number": "573-202-9790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10213 NORTHWOOD DR",
"city": "BLACKWELL",
"state": "MO",
"postal_code": "636269521",
"telephone_number": "573-202-9790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBROOM",
"first_name": "ELMA",
"middle_name": "KATHERINE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2010033339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELMA",
"last_name": "HALL",
"middle_name": "KATHERINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Blackwell, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.