Active NPI
Shirley Willmon, LPC
- Professional Counselor
- Nevada, MO
National Provider Identifier
1083755367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2006030458
- Practice address
- 1500 W Ashland St
Nevada, MO 64772-1710 - Phone
- (417) 667-2666
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2006030458 | MO | Primary |
Addresses
Primary practice location
1500 W Ashland St
Nevada, MO 64772-1710
Mailing address
1005 W Hunter St
Nevada, MO 64772-2033
Phone (417) 448-1756
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 493744502 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006030458 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233532800000",
"number": "1083755367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 W HUNTER ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647722033",
"telephone_number": "417-448-1756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 W ASHLAND ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647721710",
"telephone_number": "417-667-2666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLMON",
"first_name": "SHIRLEY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2009-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2006030458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "493744502",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nevada, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.