Individual provider Active NPI

Theresa A Eschmann, LPC

  • Mental Health Counselor
  • Imperial, MO
National Provider Identifier
1104960590
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2004036752 Issued in MO
Practice address
2158 Warwick Castle Dr
Imperial, MO 63052-3869
Phone
(314) 566-4232
Fax
(636) 287-3377
NPI assigned
Feb 18, 2007
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 507242 MO
Mental Health Counselor 101YM0800X 2004036752 MO Primary

Addresses

Primary practice location

2158 Warwick Castle Dr
Imperial, MO 63052-3869

Mailing address

2158 Warwick Castle Dr
Imperial, MO 63052-3869
Phone (314) 566-4232

Other identifiers 1

IdentifierTypeStateIssuer
497363903MedicaidMO

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
I20240430000967 MO Practitioner - Mental Health Counselor 6608216270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
507242MOMDAddiction (Substance Use Disorder) Counselor
2004036752MOMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Counseling Services of South County Addiction (Substance Use Disorder) Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: theresaeschmann@tdh.allscriptsdirect.net

Organizations & group practices 3

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": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1104960590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 WARWICK CASTLE DR",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630523869",
            "telephone_number": "314-566-4232",
            "fax_number": "636-287-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 WARWICK CASTLE DR",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630523869",
            "telephone_number": "314-566-4232",
            "fax_number": "636-287-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCHMANN",
        "first_name": "THERESA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "507242",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2004036752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497363903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Imperial, MO

Sources for this page

Verify at the official NPI Registry.