Individual provider Active NPI

Michelle Lee Concho, LPC

  • Professional Counselor
  • Festus, MO
National Provider Identifier
1265923924
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2014034196 Issued in MO
Practice address
227 Main St
Festus, MO 63028-1952
Phone
(636) 931-2700
Fax
(636) 931-5304
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2014034196 MO Primary

Addresses

Primary practice location

227 Main St
Festus, MO 63028-1952

Mailing address

1541 N Main St
Cape Girardeau, MO 63701-7028
Phone (573) 979-7630

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
I20231127000260 MO Practitioner - Mental Health Counselor 2769830181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians

Practice addresses (Care Compare)

106 N Mill St
Festus, MO 63028-1816
Phone (844) 853-8937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014034196MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jan 1, 2024 Accepting new patients
Compass Health, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1800 Community
#B
Clinton, MO 64735

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

110 N Mill St
Festus, MO 63028

1275 N Truman Blvd
Festus, MO 63028
Phone (636) 937-4686

227 Main St
Festus, MO 63028
Phone (636) 321-0101

Organizations & group practices 2

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": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1265923924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 N MAIN ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637017028",
            "telephone_number": "573-979-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952",
            "telephone_number": "636-931-2700",
            "fax_number": "636-931-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCHO",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014034196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.