Melissa Lee Bagwell, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2018045610 Issued in MO

Practice address

546 Peacock St
Rogersville, MO 65742-7750

Phone

(417) 224-0389

NPI assigned

Oct 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Lee Black Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1023652500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 PEACOCK ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657427750",
            "telephone_number": "417-224-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PEACOCK ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657427750",
            "telephone_number": "417-224-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGWELL",
        "first_name": "MELISSA",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2018045610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BLACK",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alicia Marie Baker, PA-C
• Steven R Barnes, FNP
• Kimberly Bergmann
• Melissa L Bias, MS, PLPC
• Jessica Burks, FNP-C

• Mental Health Counselor in Rogersville, MO
• Providers in Rogersville, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.