Michael D Cotter, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2017023723 Issued in MO

Practice address

1300 E Bradford Pkwy
Springfield, MO 65804-4264

Phone

(417) 761-5000

Fax

(417) 761-5011

NPI assigned

Oct 10, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Clark Community Mental Health Center

  • Community/Behavioral Health Agency
  • Monett, MO
  • NPI 1801807771

  MO

  Medicare reassignment NPD
• Shepherds Care and Consulting LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Springfield, MO
  • NPI 1679211692
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1013427657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 S Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658071445",
            "country_code": "US",
            "telephone_number": "417-761-7760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTTER",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2017023723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490047653",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Wayne Costello, MSW
• Kimberly Costello
• Tiffany Costello, PLPC
• Jill Cotner
• Kayla Cotter
• Mary A Couch, MS,LPC
• Angela K Coulter, LCSW
• James W Coulter, MD
• Terrence D Coulter, MD
• Council of Churches of the Ozarks

• All providers in Springfield, MO
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.