NPIMap

Organization Active NPI

Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
National Provider Identifier
1235244757
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
290-7523 Issued in MO
Legal business name
COMMUNITY COUNSELING CENTER
Practice address
402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone
(573) 334-1100
Fax
(573) 334-5531
NPI assigned
Aug 21, 2006
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Mrs. Lisa TolbertNPI 1386201655
Title
Chief Operating Officer
Phone
(573) 334-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 290-7523 MO Primary

Addresses

Primary practice location

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536

Mailing address

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone (573) 334-1100

Other identifiers 1

IdentifierTypeStateIssuer
562624007MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000678 MO Part B Supplier - Clinic/Group Practice 9436142460 Receives reassigned benefits from 36 practitioners
Practice locations: Cape Girardeau, MO; Fredericktown, MO; Marble Hill, MO; Perryville, MO; Ste Genevieve, MO

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

311 Garrett St
Fredericktown, MO 63645
Phone (573) 783-4104

120 N Jackson St
Perryville, MO 63775
Phone (573) 547-8305

748 Center Dr
Ste Genevieve, MO 63670
Phone (573) 880-2368

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1235244757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100",
            "fax_number": "573-334-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100",
            "fax_number": "573-334-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "TOLBERT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "573-334-1100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MO",
            "license": "290-7523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "562624007",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.