Individual provider Active NPI

Christy Ann Fleeman, MA, LPC

  • Professional Counselor
  • Columbia, MO
National Provider Identifier
1053524298
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2004032592 Issued in MO
Practice address
19 E Walnut St Ste D11010
Columbia, MO 65203-4505
Phone
(314) 472-5054
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2004032592 MO Primary

Addresses

Primary practice location

19 E Walnut St Ste D11010
Columbia, MO 65203-4505

Mailing address

9425 Carron Rd
Bloomsdale, MO 63627-9162
Phone (314) 605-2332

Other practice location 1

410 W Main St
Festus, MO 63028-1844
Phone (314) 506-2332

Other practice location 2

9425 Carron Rd
Bloomsdale, MO 63627-9162
Phone (314) 605-2332

Other identifiers 1

IdentifierTypeStateIssuer
2004032592OtherMOLPC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240612004272 MO Practitioner - Mental Health Counselor 9133661572 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2004032592MOMDProfessional Counselor

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1053524298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 CARRON RD",
            "city": "BLOOMSDALE",
            "state": "MO",
            "postal_code": "636279162",
            "telephone_number": "314-605-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E WALNUT ST STE D11010",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034505",
            "telephone_number": "314-472-5054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W Main St",
            "address_purpose": "LOCATION",
            "city": "Festus",
            "state": "MO",
            "postal_code": "630281844",
            "country_code": "US",
            "telephone_number": "314-506-2332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9425 Carron Rd",
            "address_purpose": "LOCATION",
            "city": "Bloomsdale",
            "state": "MO",
            "postal_code": "636279162",
            "country_code": "US",
            "telephone_number": "314-605-2332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEEMAN",
        "first_name": "CHRISTY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2004032592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "2004032592",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.