Active NPI
Bettina Comstock, PLPC
- Professional Counselor
- O Fallon, MO
National Provider Identifier
1104153147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2009029321
- Practice address
- 1654 Bryan Rd
O Fallon, MO 63368-4897 - Phone
- (636) 344-0433
- Fax
- (636) 410-3336
- NPI assigned
- Nov 12, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 2009029321 | MO | Primary |
Addresses
Primary practice location
1654 Bryan Rd
O Fallon, MO 63368-4897
Mailing address
1654 Bryan Rd
O Fallon, MO 63368-4897
Phone (636) 344-0433
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 |
|---|---|---|---|
| 2009029321 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Vision Youth and Family Services Inc | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- Cape Girardeau, MO
- NPI 1396950614
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1104153147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1654 BRYAN RD",
"city": "O FALLON",
"state": "MO",
"postal_code": "633684897",
"telephone_number": "636-344-0433",
"fax_number": "636-410-3336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1654 BRYAN RD",
"city": "O FALLON",
"state": "MO",
"postal_code": "633684897",
"telephone_number": "636-344-0433",
"fax_number": "636-410-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMSTOCK",
"first_name": "BETTINA",
"credential": "PLPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2009029321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.