Jamie Crouch

Individual provider Active NPI Professional Counselor · Macon, MO

NPI 1477965853 · NPPES record last updated Aug 27, 2025

Key facts

NPI
1477965853
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2014014453 (MO)
Practice address
1119 S Missouri St Ste C
Macon, MO 63552-1485
Phone
(660) 346-1737
NPI assigned
May 20, 2014
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

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 LLC (7 clinicians)

Practice addresses (Care Compare)

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

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
03060KSMDProfessional Counselor

Practice roles

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

Locations

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

Specialties & licenses

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

Addresses

Primary practice location

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

Mailing address

34394 Nevada Ave
Anabel, MO 63431-2702

Other providers in Macon, MO

All providers in Macon, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.