Individual provider Active NPI

Sue Ann Brown, LPC

  • Counselor
  • Springfield, MO
National Provider Identifier
1144356155
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
002295 Issued in MO
Practice address
3850 S National Ave
Springfield, MO 65807-5287
Phone
(417) 269-6891
Fax
(417) 269-5595
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 002295 MO Primary

Addresses

Primary practice location

3850 S National Ave
Springfield, MO 65807-5287

Mailing address

1423 N Jefferson Ave
Springfield, MO 65802-1917
Phone (417) 269-3465

Other identifiers 1

IdentifierTypeStateIssuer
132147OtherMOBLUE SHIELD

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
I20240103001262 MO Practitioner - Mental Health Counselor 4880044825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Counseling Center, Inc.Group PAC ID 9234282112, 5 clinicians

Practice addresses (Care Compare)

1864 S Kentwood Ave
Springfield, MO 65804-2323
Phone (417) 869-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 1, 2024 Accepting new patients
Gateway Counseling Center, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Lester E Cox Medical Centers Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

1864 S Kentwood Ave
Springfield, MO 65804
Phone (417) 869-8400

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

3525 S National Ave
Ste 206
Springfield, MO 65807
Phone (417) 269-9200

Organizations & group practices 4

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144356155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 N JEFFERSON AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658021917",
            "telephone_number": "417-269-3465",
            "fax_number": "417-269-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075287",
            "telephone_number": "417-269-6891",
            "fax_number": "417-269-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SUE",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "002295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "132147",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.