NPIMap

Organization Active NPI

Northland Psychological Associates LLC

Doing business as Dipoto Counseling Group

  • Mental Health Counselor
  • Liberty, MO
National Provider Identifier
1649453663
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
NORTHLAND PSYCHOLOGICAL ASSOCIATES LLC
Doing business as
Dipoto Counseling Group
Practice address
9 Victory Dr Ste 3
Liberty, MO 64068-3807
Phone
(816) 268-8501
Fax
(816) 452-5700
NPI assigned
Dec 13, 2007
Last updated
May 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Authorized official

Name
Marc C Dipoto, LPCNPI 1659330785
Title
Director
Phone
(816) 268-8501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

9 Victory Dr Ste 3
Liberty, MO 64068-3807

Mailing address

9 Victory Dr Ste 2B
Liberty, MO 64068-3807
Phone (816) 268-8501

Other practice location 1

5950 N Oak Trfy Ste 104
Kansas City, MO 64118-5164
Phone (816) 268-8501 ext. 106

Other practice location 2

5950 N Oak Trfy Ste 104
Kansas City, MO 64118-5164
Phone (816) 268-8501 ext. 106

Other practice location 3

9 Victory Dr Ste 3
Liberty, MO 64068-3807
Phone (816) 268-8501

Other names 1

  • Dipoto Counseling Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090722000289 MO Part B Supplier - Clinic/Group Practice 8729130778 Receives reassigned benefits from 3 practitioners
Practice locations: Gladstone, MO; Liberty, MO

National Provider Directory

National Provider Directory

Locations

9 Victory Dr
Ste 2B
Liberty, MO 64068
Phone (816) 268-8501

9 Victory Dr
Ste 3
Liberty, MO 64068
Phone (816) 268-8501

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1649453663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 VICTORY DR STE 2B",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683807",
            "telephone_number": "816-268-8501",
            "fax_number": "816-452-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 VICTORY DR STE 3",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683807",
            "telephone_number": "816-268-8501",
            "fax_number": "816-452-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5950 N Oak Trfy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641185164",
            "country_code": "US",
            "telephone_number": "816-268-8501 x106",
            "fax_number": "816-651-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5950 N Oak Trfy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641185164",
            "country_code": "US",
            "telephone_number": "816-268-8501 x106",
            "fax_number": "816-651-8937",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9 Victory Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Liberty",
            "state": "MO",
            "postal_code": "640683807",
            "country_code": "US",
            "telephone_number": "816-268-8501",
            "fax_number": "816-452-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHLAND PSYCHOLOGICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "DIPOTO",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "816-268-8501",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dipoto Counseling Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dipoto Counseling Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.