Individual provider Active NPI

Jean Marie Harmon, M. ED., LPC

  • Professional Counselor
  • O Fallon, MO
National Provider Identifier
1578714341
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
000214 Issued in MO
Practice address
801 S Woodlawn Ave Ste 15
O Fallon, MO 63366-7647
Phone
(636) 379-1779
Fax
(636) 634-3496
NPI assigned
Oct 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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 000214 MO Primary

Addresses

Primary practice location

801 S Woodlawn Ave Ste 15
O Fallon, MO 63366-7647

Mailing address

801 S Woodlawn Ave Ste 15
O Fallon, MO 63366-7647
Phone (636) 379-1779

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
I20231205000338 MO Practitioner - Mental Health Counselor 2264880012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Missouri, Kansas City, School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom Counseling Mo PCGroup PAC ID 6103264494, 15 clinicians

Practice addresses (Care Compare)

801 S Woodlawn Ave
Suite 16
O Fallon, MO 63366-7647
Phone (636) 379-1779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
000214MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom Counseling Mo, PC CurrentSince Mar 9, 2024 Accepting new patients

Locations

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

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.

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1578714341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S WOODLAWN AVE STE 15",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667647",
            "telephone_number": "636-379-1779",
            "fax_number": "636-634-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S WOODLAWN AVE STE 15",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667647",
            "telephone_number": "636-379-1779",
            "fax_number": "636-634-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M. ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "000214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.