Ethan Blair, MA, PLPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2023025977 Issued in MO

Practice address

724 N 22ND St
Saint Joseph, MO 64506-2604

Phone

(816) 341-1501

NPI assigned

Jun 28, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Guidance Center for Behavioral HealthcareGroup PAC ID 6800707571, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Family Guidance Center for Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Saint Joseph, MO
  • NPI 1932225141
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1194402586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 N 22ND ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062604",
            "telephone_number": "816-341-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 N 22ND ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062604",
            "telephone_number": "816-341-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "ETHAN",
        "credential": "MA, PLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2023025977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie Lee Birchansky, MD
• Alejandro Blachar, M.D
• Deborah Blachar, MD
• Michelle A Black
• Mark Allan Blackledge, O.D.
• David A Blaker, CRNA
• Terra Brean Blanchard, CPM
• Kevin Bland
• Amber Evelyn Blattner, M.A., CCC-SLP
• Jessica Nicole Bledsoe, PTA

• Counselor in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.