Jamie L Audsley, PLMFT
Individual provider Active NPI Marriage & Family Therapist · Springfield, MO
NPI 1467066159 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1467066159
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 2021035898 (MO)
- Practice address
- 1300 E Bradford Pkwy
Springfield, MO 65804-4264 - Phone
- (417) 761-5000
- Fax
- (417) 761-5111
- NPI assigned
- Sep 1, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2730 E Chestnut Expy
Springfield, MO 65802-2555
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260512001255 | MO | Practitioner - Marriage and Family Therapist | 7517436215 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021035898 | MO | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Branch Counseling | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2021035898 | MO | Yes |
Addresses
Primary practice location
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Mailing address
1300 E Bradford Pkwy
Springfield, MO 65804-4264
Phone (417) 761-5000
Other providers in Springfield, MO
- Eric Loyal Atkinson
- Neva Ileen Atteberry
- Benjamin Louis Atwell Jr.
- Steven Dale Atwood
- James Matthew Aubuschon
- Krystal August
- Ashley Marie Aumiller
- Austen-Dooley Company
- Ashley Liddell Austin
- Craig Austin
All providers in Springfield, MO · Marriage & Family Therapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.