Active NPI
Lydia Alpha Mabbitt, LPC
- Professional Counselor
- Poplar Bluff, MO
National Provider Identifier
1013024454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2000158656
- Practice address
- 3001 Warrior LN
Poplar Bluff, MO 63901-8685 - Phone
- (573) 686-1200
- Fax
- (573) 686-1029
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 2000158656 | MO | Primary |
Addresses
Primary practice location
3001 Warrior LN
Poplar Bluff, MO 63901-8685
Mailing address
PO Box 280
Poplar Bluff, MO 63902-0280
Phone (573) 686-1200
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431116734 | Other | EAP INTERFACE | |
| 431116734 | Other | EAP WELLPOINT | |
| 9877 | Other | MO | FEI BEHAVIORAL |
| 1013024454 | Other | BLUE CROSS BLUE SHIELD | |
| 431116734 | Other | EAP PEOPLE RESOURCES | |
| 2613 | Other | MO | EAP IMPACT |
| 11784624 | Other | MO | CAQH |
| 431116734 | Other | EAP CERIDIAN | |
| 494997521 | Medicaid | MO | |
| 890435 | Other | MO | HEALTHLINK PPO |
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 |
|---|---|---|---|
| 2000158656 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240272000000",
"number": "1013024454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 280",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639020280",
"telephone_number": "573-686-1200",
"fax_number": "573-686-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 WARRIOR LN",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639018685",
"telephone_number": "573-686-1200",
"fax_number": "573-686-1029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABBITT",
"first_name": "LYDIA",
"middle_name": "ALPHA",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2009-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2000158656",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAP INTERFACE",
"identifier": "431116734",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAP WELLPOINT",
"identifier": "431116734",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEI BEHAVIORAL",
"identifier": "9877",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1013024454",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAP PEOPLE RESOURCES",
"identifier": "431116734",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAP IMPACT",
"identifier": "2613",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11784624",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EAP CERIDIAN",
"identifier": "431116734",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "494997521",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK PPO",
"identifier": "890435",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.