Angela K Coulter, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2002019366 Issued in MO

Practice address

3814 S. Cox Ave.
Springfield, MO 65807

Phone

(417) 766-5566

Fax

(417) 269-7212

NPI assigned

Jun 24, 2005

Last updated

Mar 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Cultivating Wellness

  • Adult Mental Health Clinic/Center
  • Springfield, MO
  • NPI 1275199804
  Authorized official Same address or phone

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1235135153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 S. COX AVE.",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65807",
            "telephone_number": "417-766-5566",
            "fax_number": "417-269-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 S. COX AVE.",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65807",
            "telephone_number": "417-766-5566",
            "fax_number": "417-269-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "ANGELA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002019366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495979205",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Costello, PLPC
• Jill Cotner
• Kayla Cotter
• Michael D Cotter, MS, LPC
• Mary A Couch, MS,LPC
• James W Coulter, MD
• Terrence D Coulter, MD
• Council of Churches of the Ozarks (Daybreak Adult Day Care / Eldercare Transit Service)
• Council of Churches of the Ozarks (Daybreak Adult Day Care / Elder Care Transit Service)
• Counseling Associates of Springfield, Inc.

• Clinical Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.