Individual provider Active NPI

Charles L Quinn

  • Professional Counselor
  • Waynesville, MO
National Provider Identifier
1619430519
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2019009356 Issued in MO
Practice address
Hope Connections LLC 704 Historic Rte. 66W Suite 101
Waynesville, MO 65583
Phone
(573) 452-1311
NPI assigned
Apr 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2019009356 MO Primary
Counselor 101Y00000X 2019009356 MO

Addresses

Primary practice location

Hope Connections LLC 704 Historic Rte. 66W Suite 101
Waynesville, MO 65583

Mailing address

Hope Connections LLC 704 Historic Rte. 66W Suite 101
Waynesville, MO 65583
Phone (573) 452-1311

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
I20241104002714 MO Practitioner - Mental Health Counselor 0345773982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Connections, LLCGroup PAC ID 6507250677, 9 clinicians

Practice addresses (Care Compare)

704 Historic 66
Suite 101
Waynesville, MO 65583-8322
Phone (573) 433-4846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Connections, LLC Professional CurrentSince Aug 29, 2024 Accepting new patients

Locations

103 W 10th St
Rolla, MO 65401
Phone (573) 433-4846

704 Route 66 W
Ste 101
Waynesville, MO 65583
Phone (573) 433-4846

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1619430519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HOPE CONNECTIONS LLC 704 HISTORIC RTE. 66W SUITE 101",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-452-1311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOPE CONNECTIONS LLC 704 HISTORIC RTE. 66W SUITE 101",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "65583",
            "telephone_number": "573-452-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "CHARLES",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-09",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2019009356",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2019009356",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, MO

Sources for this page

Verify at the official NPI Registry.