Individual provider Active NPI

Kaitley Rose Teter, LPC

  • Professional Counselor
  • Kirksville, MO
National Provider Identifier
1265997464
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2023005075 Issued in MO
Practice address
105 Pfeiffer Ave
Kirksville, MO 63501-5047
Phone
(660) 665-4612
NPI assigned
Feb 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 2023005075 MO Primary

Addresses

Primary practice location

105 Pfeiffer Ave
Kirksville, MO 63501-5047

Mailing address

105 Pfeiffer Ave
Kirksville, MO 63501-5047
Phone (660) 665-4612

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
I20250331000343 MO Practitioner - Mental Health Counselor 9638692734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Twain Association for Mental Health IncGroup PAC ID 9436376969, 25 clinicians

Practice addresses (Care Compare)

105 Pfeiffer Ave
Kirksville, MO 63501-5047
Phone (660) 665-4612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023005075MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Twain Association for Mental Health, Inc CurrentSince Mar 6, 2025 Accepting new patients
Mark Twain Association for Mental Health, Inc. CurrentSince Mar 6, 2025 Accepting new patients

Locations

154 Forrest Dr
Hannibal, MO 63401
Phone (573) 221-2120

105 Pfeiffer Ave
Kirksville, MO 63501
Phone (660) 627-5757

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": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1265997464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 PFEIFFER AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015047",
            "telephone_number": "660-665-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 PFEIFFER AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635015047",
            "telephone_number": "660-665-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETER",
        "first_name": "KAITLEY",
        "middle_name": "ROSE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2023005075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.