David L Lemmon, PSYD, LPC

Key facts

NPI

1457533481

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

2003032059 (MO)

Practice address

1322 S Campbell Ave
Springfield, MO 65807-1445

Phone

(417) 761-5000

NPI assigned

Nov 30, 2007

Sex

Male

Sole proprietor

No

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.

• Bolivar Family Counseling Center LLC Psychologist · Buffalo, MO · NPI 1982895595
  NPD (past) PROFESSIONAL

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 1, 2019.

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1457533481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E BRADFORD PKWY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044264",
            "telephone_number": "417-761-5000",
            "fax_number": "417-761-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 S CAMPBELL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658071445",
            "telephone_number": "417-761-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMMON",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-30",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2003032059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13870714",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497625509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Samantha Lemoine, MS, LPC
• Daphne R Lemon, MD
• Kathleen F Lemon, PSY.D.
• Eli B Lemonier, O.D.
• Paige L Lemuz, MA, LPC

All providers in Springfield, MO · Professional Counselor in Missouri