Vicki Sue Branstetter, PLPC

Individual provider Active NPI Professional Counselor · Fredericktown, MO

NPI 1407328503 · NPPES record last updated Dec 30, 2018

Key facts

NPI
1407328503
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2018039118 (MO)
Practice address
600 Sargent LN
Fredericktown, MO 63645-7526
Phone
(573) 783-4400
Fax
(573) 783-4409
NPI assigned
Dec 30, 2018
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2018039118MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Tabernacle World Outreach Inc Past
since Jul 10, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2018039118 MO Yes

Addresses

Primary practice location

600 Sargent LN
Fredericktown, MO 63645-7526

Mailing address

600 Sargent LN
Fredericktown, MO 63645-7526
Phone (573) 783-4400

Other providers in Fredericktown, MO

All providers in Fredericktown, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.