Organization Active NPI

Premier Therapies, LLC

  • Counseling Psychologist
  • Columbia, MO
National Provider Identifier
1700148160
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
PREMIER THERAPIES, LLC
Practice address
2100 E. Broadway
Suite 206
Columbia, MO 65201-6082
Phone
(573) 443-4038
Fax
(573) 657-1125
NPI assigned
Jun 12, 2012
Last updated
Jun 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Authorized official

Name
Ms. Diane La Mar, L.P.C.NPI 1831231448
Title
Owner
Phone
(573) 443-4038

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 000750 MO
Mental Health Counselor 101YM0800X 000723 MO
Psychologist 103T00000X 2004024724 MO
Counseling Psychologist 103TC1900X NU Primary

Addresses

Primary practice location

2100 E. Broadway
Suite 206
Columbia, MO 65201-6082

Mailing address

2001 Winchester Drive
Columbia, MO 65202-3170
Phone (573) 443-4038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240723000317 MO Part B Supplier - Clinic/Group Practice 2769928118 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MO

National Provider Directory

National Provider Directory

Locations

2100 E Broadway
Ste 206
Columbia, MO 65201
Phone (573) 443-4038

1406 Missouri Blvd
Ste F
Jefferson City, MO 65109

Practitioners & affiliated clinicians

Practitioners 1

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": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1700148160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 WINCHESTER DRIVE",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652023170",
            "telephone_number": "573-443-4038",
            "fax_number": "573-657-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E. BROADWAY",
            "address_2": "SUITE 206",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652016082",
            "telephone_number": "573-443-4038",
            "fax_number": "573-657-1125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER THERAPIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "LA MAR",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-443-4038",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.P.C."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "000750",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "000723",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2004024724",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.