Barbara Ann Proctor, M.A., QMHP, LPC

Individual provider Active NPI Professional Counselor · Richland, MO

NPI 1508055302 · NPPES record last updated May 23, 2023

Key facts

NPI
1508055302
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
2020040389 (MO)
Practice address
112 McClurg Ave
Richland, MO 65556
Phone
(573) 765-5141
Fax
(573) 765-3824
NPI assigned
Oct 17, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 10

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, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richland Medical Center, Inc. (29 clinicians)

Practice addresses (Care Compare)

112 W McClurg Ave
Richland, MO 65556-7601
Phone (877) 406-2662

304 W Washington Ave
Richland, MO 65556-7101
Phone (573) 836-7053

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
I20240109004559 MO Practitioner - Mental Health Counselor 9436500964 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180007422ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Medical Center, Inc. Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 180007422 IL
Professional Counselor 101YP2500X 2020040389 MO Yes

Addresses

Primary practice location

112 McClurg Ave
Richland, MO 65556

Mailing address

PO Box 777
Richland, MO 65556-0777
Phone (573) 708-7600

Other practice location 1

24670 Safe Rd
Waynesville, MO 65583-8309
Phone (847) 226-1714

Other practice location 2

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814
Phone (847) 952-7646 ext. 5730

Other practice location 3

1450 E 10th St
Rolla, MO 65401-3648
Phone (844) 853-8937

Other identifiers

IdentifierTypeStateIssuer
1508055302MedicaidMO

Other names

  • Barbara Ann Numerowski Former name

Other providers in Richland, MO

All providers in Richland, MO · Professional Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.