NPIMap

Organization Active NPI

Walking Peace

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boonville, MO
National Provider Identifier
1467289983
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WALKING PEACE
Practice address
413 E Spring St
Boonville, MO 65233-1573
Phone
(573) 289-8495
Fax
(660) 882-7137
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Ms. Laura S Haines, MA, LPCNPI 1457043580
Title
Owner
Phone
(573) 289-8495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

413 E Spring St
Boonville, MO 65233-1573

Mailing address

413 E Spring St
Boonville, MO 65233-1573
Phone (573) 289-8495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241227002609 MO Part B Supplier - Clinic/Group Practice 0840727160 Receives reassigned benefits from 1 practitioner
Practice locations: Boonville, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1467289983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 E SPRING ST",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331573",
            "telephone_number": "573-289-8495",
            "fax_number": "660-882-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 E SPRING ST",
            "city": "BOONVILLE",
            "state": "MO",
            "postal_code": "652331573",
            "telephone_number": "573-289-8495",
            "fax_number": "660-882-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALKING PEACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "HAINES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-289-8495",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.