Individual provider Active NPI

Andrea Dana Lee Phillips, LPC

  • Professional Counselor
  • Joplin, MO
National Provider Identifier
1104162775
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2012037385 Issued in MO
Practice address
707 Pearl Street
Suite B
Joplin, MO 64801-1241
Phone
(417) 781-4552
NPI assigned
Dec 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 2012037385 MO Primary

Addresses

Primary practice location

707 Pearl Street
Suite B
Joplin, MO 64801-1241

Mailing address

707 Pearl Street
Suite B
Joplin, MO 64801-1241
Phone (417) 781-4552

Other names 1

  • Dana Lee Phillips Former name

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

LicenseStateTypeSpecialty
2012037385MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1356739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1104162775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PEARL STREET",
            "address_2": "SUITE B",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011241",
            "telephone_number": "417-781-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PEARL STREET",
            "address_2": "SUITE B",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648011241",
            "telephone_number": "417-781-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "ANDREA",
        "middle_name": "DANA LEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-29",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2012037385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "PHILLIPS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.