Tina Marie Churchill, MA, LPC
Individual provider Active NPI Mental Health Counselor · Warrenton, MO
NPI 1124276563 · NPPES record last updated Apr 8, 2019
Key facts
- NPI
- 1124276563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 2005010044 (MO)
- Practice address
- 1428 N. Highway 47
Suite a
Warrenton, MO 63383-1375 - Phone
- (636) 359-6445
- Fax
- (636) 456-6216
- NPI assigned
- Aug 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005010044 | MO | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Churchill Family Counseling | Professional | Past | Accepting new patients |
| Generations Counseling Group, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Mental Health Counselor | 101YM0800X | 2005010044 | MO | Yes |
Addresses
Primary practice location
1428 N. Highway 47
Suite a
Warrenton, MO 63383-1375
Mailing address
1428 N State Highway 47 Ste C
Warrenton, MO 63383-1375
Phone (636) 359-6445
Other providers in Warrenton, MO
- Patricka Caldera
- Camelot Hospice Care LLC
- Janelle S Carron
- Antoinette Chivetta
- Churchill Family Counseling
- Tracy Lynn Clark
- Clarkson Optometry Inc
- Claybrooke Medical Group, LLC
- Kimbereley K Coleman
- Ellen Hill Colgan
All providers in Warrenton, MO · Mental Health Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.