Individual provider Active NPI

Mickee Lea Anderson

  • Counselor
  • Park Hills, MO
National Provider Identifier
1205779303
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2023050828 Issued in MO
Practice address
311 Edgewood St
Park Hills, MO 63601-2043
Phone
(573) 747-6721
NPI assigned
Apr 13, 2026
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2023050828 MO Primary

Addresses

Primary practice location

311 Edgewood St
Park Hills, MO 63601-2043

Mailing address

311 Edgewood St
Park Hills, MO 63601-2043

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
2023050828MOMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1776038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1205779303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 EDGEWOOD ST",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 EDGEWOOD ST",
            "city": "PARK HILLS",
            "state": "MO",
            "postal_code": "636012043",
            "telephone_number": "573-747-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MICKEE",
        "middle_name": "LEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-13",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2023050828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Hills, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.