NPIMap

Organization Active NPI

Solid Rock Christian Counseling, Inc

  • Mental Health Counselor
  • Poplar Bluff, MO
National Provider Identifier
1699836403
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
002436 Issued in MO
Legal business name
SOLID ROCK CHRISTIAN COUNSELING, INC
Practice address
2725 N Westwood Blvd
Ste.5a
Poplar Bluff, MO 63901-2346
Phone
(573) 785-0333
Fax
(573) 785-0333
NPI assigned
Dec 13, 2006
Last updated
May 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Mrs. Melissa M Allen
Title
Office Manager
Phone
(573) 785-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 002436 MO Primary

Addresses

Primary practice location

2725 N Westwood Blvd
Ste.5a
Poplar Bluff, MO 63901-2346

Mailing address

2725 N Westwood Blvd
Ste.5a
Poplar Bluff, MO 63901-2346
Phone (573) 785-0333

Other identifiers 6

IdentifierTypeStateIssuer
1699836403OtherMOVALUE OPTIONS
1699836403OtherMOHEALTHLINK, INC
1699836403MedicaidMO
1699836403OtherMOMEDICARE CMS
1699836403OtherMOANTHEM BLUE CROSS BLUE SHIELD
1699836403OtherMOUNITED HEALTHCARE

National Provider Directory

National Provider Directory

Locations

2725 N Westwood Blvd
Ste 5A
Poplar Bluff, MO 63901
Phone (573) 785-0333

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1699836403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 N WESTWOOD BLVD",
            "address_2": "STE.5A",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012346",
            "telephone_number": "573-785-0333",
            "fax_number": "573-785-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 N WESTWOOD BLVD",
            "address_2": "STE.5A",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012346",
            "telephone_number": "573-785-0333",
            "fax_number": "573-785-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLID ROCK CHRISTIAN COUNSELING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-785-0333",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "002436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "1699836403",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK, INC",
            "identifier": "1699836403",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699836403",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CMS",
            "identifier": "1699836403",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "1699836403",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1699836403",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; 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.