Individual provider Active NPI

Jamie Crouch

  • Professional Counselor
  • Macon, MO
National Provider Identifier
1477965853
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2014014453 Issued in MO
Practice address
1119 S Missouri St Ste C
Macon, MO 63552-1485
Phone
(660) 346-1737
NPI assigned
May 20, 2014
Last updated
Aug 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 03060 KS
Professional Counselor 101YP2500X 2014014453 MO Primary

Addresses

Primary practice location

1119 S Missouri St Ste C
Macon, MO 63552-1485

Mailing address

34394 Nevada Ave
Anabel, MO 63431-2702

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
I20240313002251 MO Practitioner - Mental Health Counselor 2860838786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Oak Counseling LLCGroup PAC ID 3173613163, 7 clinicians

Practice addresses (Care Compare)

1221 Broadway
Hannibal, MO 63401-4005
Phone (573) 221-2111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03060KSMDProfessional Counselor
2014014453MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
White Oak Counseling, LLC CurrentSince Jan 23, 2024 Accepting new patients

Locations

1221 Broadway
Hannibal, MO 63401
Phone (573) 221-2111

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, 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": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1477965853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34394 NEVADA AVE",
            "city": "ANABEL",
            "state": "MO",
            "postal_code": "634312702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 S MISSOURI ST STE C",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521485",
            "telephone_number": "660-346-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROUCH",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "03060",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014014453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, MO

Sources for this page

Verify at the official NPI Registry.