NPIMap

Organization Active NPI

Bootheel Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sikeston, MO
National Provider Identifier
1386789139
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
2748045 Issued in MO
Legal business name
BOOTHEEL COUNSELING SERVICES
Practice address
760 Plantation Blvd
Sikeston, MO 63801-5736
Phone
(573) 471-0800
Fax
(573) 471-0810
NPI assigned
Feb 20, 2007
Last updated
Feb 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Authorized official

Name
Mr. David TerrellNPI 1851632442
Title
Excutive Director
Phone
(573) 471-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2748045 MO Primary

Addresses

Primary practice location

760 Plantation Blvd
Sikeston, MO 63801-5736

Mailing address

760 Plantation Blvd
P.O. Box 1043
Sikeston, MO 63801-5736
Phone (573) 471-0800

Other identifiers 1

IdentifierTypeStateIssuer
562823906MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040802000153 MO Part B Supplier - Clinic/Group Practice 5496725145 Receives reassigned benefits from 32 practitioners
1 other NPI on this enrollment
Practice locations: Sikeston, MO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Bootheel Counseling Ser8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1386789139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 PLANTATION BLVD",
            "address_2": "P.O. BOX 1043",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015736",
            "telephone_number": "573-471-0800",
            "fax_number": "573-471-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 PLANTATION BLVD",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015736",
            "telephone_number": "573-471-0800",
            "fax_number": "573-471-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTHEEL COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "TERRELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXCUTIVE DIRECTOR",
        "authorized_official_telephone_number": "573-471-0800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MO",
            "license": "2748045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "562823906",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sikeston, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.