NPIMap

Individual provider Active NPI

Carol Louise Dippold, LCSW, LPC

  • Clinical Social Worker
  • Cape Girardeau, MO
National Provider Identifier
1104381151
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
002562 Issued in MO
Practice address
1021 Kingsway Dr Ste 3
Cape Girardeau, MO 63701-3600
Phone
(573) 335-7929
Fax
(573) 335-6445
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 000855 MO
Clinical Social Worker 1041C0700X 002562 MO Primary

Addresses

Primary practice location

1021 Kingsway Dr Ste 3
Cape Girardeau, MO 63701-3600

Mailing address

1021 Kingsway Dr Ste 3
Cape Girardeau, MO 63701-3600
Phone (573) 335-7929

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vjohnston_acs@att.net Direct Associated Counseling Services, Inc.

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
000855MOMDCounselor
002562MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Family & Children'S Services of Missouri Past Accepting new patients
Lutheran Family and Children'S Services PastSince May 9, 2021 Accepting new patients

Organizations & group practices 2

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1104381151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 KINGSWAY DR STE 3",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637013600",
            "telephone_number": "573-335-7929",
            "fax_number": "573-335-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 KINGSWAY DR STE 3",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637013600",
            "telephone_number": "573-335-7929",
            "fax_number": "573-335-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPPOLD",
        "first_name": "CAROL",
        "middle_name": "LOUISE",
        "credential": "LCSW, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "000855",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "002562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vjohnston_acs@att.net",
            "affiliation": "Y",
            "affiliationName": "Associated Counseling Services, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct",
            "address_1": "1021 Kingsway Dr Ste 3",
            "city": "Cape Girardeau",
            "state": "MO",
            "country_code": "US",
            "postal_code": "637013600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.