Dustan Yates Campbell
Individual provider Active NPI Professional Counselor · Nevada, MO
NPI 1033707641 · NPPES record last updated Jan 8, 2021
Key facts
- NPI
- 1033707641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2020040530 (MO)
- Practice address
- 1500 W Ashland St
Nevada, MO 64772-1710 - Phone
- (314) 712-3411
- NPI assigned
- Jan 8, 2021
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020040530 | MO | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | 2020040530 | MO | Yes |
Addresses
Primary practice location
1500 W Ashland St
Nevada, MO 64772-1710
Mailing address
128 S Clay St
Nevada, MO 64772-3132
Phone (314) 712-3411
Other providers in Nevada, MO
- Casey Lauren Brown
- Thomas Richard Bunton
- Butler-Davidson Counseling Services
- Debra Joan Butler
- Ellen E Byergo
- Candice Moore Inc
- Adela Casa
- Courtney D Cason
- Challenge N' Change, Inc.
- Children'S Center
All providers in Nevada, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.