Individual provider Active NPI

William L Sutherland, MED

  • Professional Counselor
  • Columbia, MO
National Provider Identifier
1720368012
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2011026062 Issued in MO
Practice address
601 W Nifong Blvd Ste 5a
Columbia, MO 65203-6804
Phone
(573) 424-3316
NPI assigned
Aug 18, 2011
Last updated
Aug 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2011026062 MO Primary

Addresses

Primary practice location

601 W Nifong Blvd Ste 5a
Columbia, MO 65203-6804

Mailing address

654 W Bethel Dr
Columbia, MO 65203-9696
Phone (573) 424-3316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
2011026062MOMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1720368012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 W BETHEL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652039696",
            "telephone_number": "573-424-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W NIFONG BLVD STE 5A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652036804",
            "telephone_number": "573-424-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2011026062",
            "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 Aug 18, 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.