Active NPI
Gary Lee Balfour, PROV. LIC. COUNSELOR
- Professional Counselor
- Joplin, MO
National Provider Identifier
1285837005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2007009752
- Practice address
- 211 S Main St
Joplin, MO 64801-2366 - Phone
- (417) 782-1290
- NPI assigned
- Jun 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2007009752 | MO | Primary |
Addresses
Primary practice location
211 S Main St
Joplin, MO 64801-2366
Mailing address
1097 Reinmiller Rd
Joplin, MO 64804-7740
Phone (417) 782-3974
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2007009752 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285837005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1097 REINMILLER RD",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648047740",
"telephone_number": "417-782-3974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S MAIN ST",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648012366",
"telephone_number": "417-782-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALFOUR",
"first_name": "GARY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PROV. LIC. COUNSELOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2007009752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.