Individual provider Active NPI

Susan Wulff, LPC

  • Professional Counselor
  • Raymore, MO
National Provider Identifier
1295147692
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2009029406 Issued in MO
Practice address
1010 Remington PLZ
Raymore, MO 64083-8640
Phone
(816) 318-4430
NPI assigned
May 20, 2014
Last updated
Oct 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2009029406 MO
Professional Counselor 101YP2500X 2009029406 MO Primary

Addresses

Primary practice location

1010 Remington PLZ
Raymore, MO 64083-8640

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

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
I20231121003510 MO Practitioner - Mental Health Counselor 3173971660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009029406MOMDProfessional 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
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

1600 N Missouri Ave
Marceline, MO 64658
Phone (660) 376-2038

1010 Remington Plz
Raymore, MO 64083
Phone (816) 318-4430

307 S Broadway
Salisbury, MO 65281
Phone (660) 388-6446

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1295147692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 REMINGTON PLZ",
            "city": "RAYMORE",
            "state": "MO",
            "postal_code": "640838640",
            "telephone_number": "816-318-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULFF",
        "first_name": "SUSAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2009029406",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2009029406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymore, MO

Sources for this page

Verify at the official NPI Registry.