Elizabeth Bales, PLPC

Key facts

NPI

1508934571

Entity type

Individual (NPI type 1)

Primary specialty

Professional Counselor 101YP2500X

License

2006034078 (MO)

Practice address

1722 S Glenstone Ave Ste TT
Springfield, MO 65804-1517

Phone

(417) 881-2848

Fax

(417) 881-2640

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508934571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 N GOLDEN AVE TRLR 66",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658032277",
            "telephone_number": "417-350-0395",
            "fax_number": "417-881-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 S GLENSTONE AVE STE TT",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658041517",
            "telephone_number": "417-881-2848",
            "fax_number": "417-881-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALES",
        "first_name": "ELIZABETH",
        "credential": "PLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2006034078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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