Individual provider Active NPI

Robin J Lukefahr, LPC

  • Professional Counselor
  • Kirksville, MO
National Provider Identifier
1477648715
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2003032101 Issued in MO
Practice address
1510 Crown Dr
Kirksville, MO 63501-2553
Phone
(660) 627-3621
Fax
(660) 627-5798
NPI assigned
Oct 3, 2006
Last updated
Nov 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2003032101 MO Primary

Addresses

Primary practice location

1510 Crown Dr
Kirksville, MO 63501-2553

Mailing address

1416 Crown Dr
Kirksville, MO 63501-2548
Phone (660) 627-5757

Other names 1

  • Robin Renne Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240701001120 MO Practitioner - Mental Health Counselor 4284178393 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003032101MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ozark Center CurrentSince Jun 3, 2024 Accepting new patients
Ozark Center CurrentSince Jun 3, 2024 Accepting new patients
Northeast Missouri Health Council, Inc. Professional Past Accepting new patients
Northeast Missouri Health Council, Inc. Professional Past Accepting new patients

Locations

3901 E 32nd St
Joplin, MO 64804
Phone (417) 347-7567

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1477648715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CROWN DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012548",
            "telephone_number": "660-627-5757",
            "fax_number": "660-627-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 CROWN DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012553",
            "telephone_number": "660-627-3621",
            "fax_number": "660-627-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKEFAHR",
        "first_name": "ROBIN",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2003032101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBIN",
            "last_name": "RENNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.