Tricia L Phillips, LPC, NCC, CCJP

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2005038745 Issued in MO

Practice address

13160 County Rd. 3610
St. James, MO 65559-9989

Phone

(573) 265-3251

Fax

(573) 265-8363

NPI assigned

Nov 20, 2006

Last updated

Sep 11, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tricia L Bolerjack Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252627200000",
    "number": "1649344995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11825 PRIVATE DRIVE 5136",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654015909",
            "telephone_number": "573-647-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 COUNTY RD. 3610",
            "city": "ST. JAMES",
            "state": "MO",
            "postal_code": "655599989",
            "telephone_number": "573-265-3251",
            "fax_number": "573-265-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TRICIA",
        "middle_name": "L",
        "credential": "LPC, NCC, CCJP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2009-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2005038745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "BOLERJACK",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Nicole O'Malley, M.D,
• Caitlyn Renee Ostrowski, DC
• Kim Parker
• Brandy Ann Michelle Pfeifer, LPC
• Phelps County Regional Medical Center (Phelps Health Medical Group St James)
• Preventive Healthcare
• Emma Reichel
• Scattered Oaks Inc.
• Petra Christina Scholz Gould, LPC, NCC
• Lisa L. Schramek, APN-BC, FPA

• Counselor in Saint James, MO
• Providers in Saint James, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.