NPIMap

Organization Active NPI

Brian a Fidler

Doing business as Epic Counseling Group

  • Professional Counselor
  • Independence, MO
National Provider Identifier
1346682994
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BRIAN A FIDLER
Doing business as
Epic Counseling Group
Practice address
4200 Little Blue Pkwy
Suite 360
Independence, MO 64057-8312
Phone
(816) 622-3171
NPI assigned
Jul 24, 2013
Last updated
Oct 9, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
EPIC COUNSELING GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Authorized official

Name
Brian Fidler
Title
President
Phone
(816) 622-3171

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X MO Primary
Clinical Psychologist 103TC0700X MO
Clinical Social Worker 1041C0700X MO

Addresses

Primary practice location

4200 Little Blue Pkwy
Suite 360
Independence, MO 64057-8312

Mailing address

4200 Little Blue Pkwy
Suite 360
Independence, MO 64057-8312

Other names 1

  • Epic Counseling Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131010000845 MO Part B Supplier - Clinic/Group Practice 1254565054 Receives reassigned benefits from 7 practitioners
Practice locations: Independence, MO

National Provider Directory

National Provider Directory
Part of
Brian a Fidler

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1346682994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 LITTLE BLUE PKWY",
            "address_2": "SUITE 360",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640578312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 LITTLE BLUE PKWY",
            "address_2": "SUITE 360",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640578312",
            "telephone_number": "816-622-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN A FIDLER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EPIC COUNSELING GROUP",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "FIDLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-622-3171"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Epic Counseling Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.