Individual provider Active NPI

Cibele F.C. Elliott, LPC

  • Counselor
  • Lake Ozark, MO
National Provider Identifier
1053750869
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
752 Bagnell Dam Blvd Ste B
Lake Ozark, MO 65049-8716
Phone
(573) 693-1119
Fax
(573) 557-4163
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MO Primary

Addresses

Primary practice location

752 Bagnell Dam Blvd Ste B
Lake Ozark, MO 65049-8716

Mailing address

752 Bagnell Dam Blvd Ste B
Lake Ozark, MO 65049-8716
Phone (573) 693-1119

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
I20240301002149 MO Practitioner - Mental Health Counselor 0244675155 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

752 Bagnell Dam Blvd
Suite B
Lake Ozark, MO 65049-8716
Phone (573) 693-1119

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness Institute LLC Counselor CurrentSince Dec 30, 2023 Accepting new patients

Locations

752 Bagnell Dam Blvd
Ste B
Lake Ozark, MO 65049
Phone (573) 693-1119

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1053750869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "752 BAGNELL DAM BLVD STE B",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498716",
            "telephone_number": "573-693-1119",
            "fax_number": "573-557-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "752 BAGNELL DAM BLVD STE B",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "650498716",
            "telephone_number": "573-693-1119",
            "fax_number": "573-557-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CIBELE",
        "middle_name": "F.C.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ozark, MO

Sources for this page

Verify at the official NPI Registry.