Individual provider Active NPI

Paul Buford, PHD, LPC

  • Professional Counselor
  • O'Fallon, MO
National Provider Identifier
1356041727
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2014004877 Issued in MO
Practice address
8759 Veterans Memorial Pkwy
O Fallon, MO 63366-7538
Phone
(636) 345-1106
Fax
(636) 356-1319
NPI assigned
Mar 6, 2023
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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 2014004877 MO Primary

Addresses

Primary practice location

8759 Veterans Memorial Pkwy
O Fallon, MO 63366-7538

Mailing address

230 Gobbler Dr
Troy, MO 63379-2578
Phone (636) 345-1106

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
I20240807000769 MO Practitioner - Mental Health Counselor 4587101654 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
Tim Bizelli Counseling LLCGroup PAC ID 8820535081, 4 clinicians

Practice addresses (Care Compare)

5933 S Hwy 94
Suite 101
Weldon Spring, MO 63304-5608
Phone (636) 345-1106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2014004877MOMDProfessional Counselor

Organizations & group practices 1

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1356041727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 GOBBLER DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792578",
            "telephone_number": "636-345-1106",
            "fax_number": "636-356-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8759 VETERANS MEMORIAL PKWY",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667538",
            "telephone_number": "636-345-1106",
            "fax_number": "636-356-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFORD",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014004877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

Verify at the official NPI Registry.