Marissa L Fort-Conrad, NCC, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2023005080 Issued in MO

Practice address

1328 W Broadway St Ste 2
Webb City, MO 64870-1620

Phone

(417) 719-1407

NPI assigned

Jan 7, 2025

Last updated

Jan 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marissa L Fort Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1306655022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 E SADIE CT",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648014821",
            "telephone_number": "417-621-5575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 W BROADWAY ST STE 2",
            "city": "WEBB CITY",
            "state": "MO",
            "postal_code": "648701620",
            "telephone_number": "417-719-1407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORT-CONRAD",
        "first_name": "MARISSA",
        "middle_name": "L",
        "credential": "NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2023005080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "FORT",
            "middle_name": "L",
            "credential": "NCC, PLPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Webb City, MO
• Providers in Webb City, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.