Individual provider Active NPI

Kyle J Schott, LPC

  • Professional Counselor
  • Cape Girardeau, MO
National Provider Identifier
1619001344
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1999142312 Issued in MO
Practice address
402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone
(573) 334-1100
Fax
(573) 651-4345
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 1999142312 MO Primary

Addresses

Primary practice location

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536

Mailing address

436 Green Acres St
Cape Girardeau, MO 63701-7013
Phone (573) 471-0800

Other identifiers 1

IdentifierTypeStateIssuer
494736705MedicaidMO

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
I20231201002534 MO Practitioner - Mental Health Counselor 6507214426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Counseling CenterGroup PAC ID 9436142460, 22 clinicians

Practice addresses (Care Compare)

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone 57333411002780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Center CurrentSince Jan 1, 2024 Accepting new patients
Community Counseling Center Past Accepting new patients

Locations

402 S Silver Springs Rd
Cpe Girardeau, MO 63703
Phone (573) 334-1100

309 Garrett St
Fredericktown, MO 63645
Phone (573) 783-4104

406 N Spring St
Ste 2
Perryville, MO 63775
Phone (573) 547-8305

820 Park Dr
Ste Genevieve, MO 63670
Phone (573) 883-7407

Organizations & group practices 2

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1619001344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 GREEN ACRES ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637017013",
            "telephone_number": "573-471-0800",
            "fax_number": "573-471-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100",
            "fax_number": "573-651-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOTT",
        "first_name": "KYLE",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "1999142312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "494736705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.