Lisa M Spore, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2011016318 Issued in MO

Practice address

307 S West St
Nixa, MO 65714-8413

Phone

(417) 494-5031

Fax

(417) 551-4146

NPI assigned

Jun 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nixa Behavioral Services, LLC

  • Professional Counselor
  • Nixa, MO
  • NPI 1952755019
  NPD

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1720372659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S WEST ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148413",
            "telephone_number": "417-494-5031",
            "fax_number": "417-551-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S WEST ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657148413",
            "telephone_number": "417-494-5031",
            "fax_number": "417-551-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORE",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2011016318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Kaitlyn Smith
• Vicky Kate Smith
• Special Force Family Ministries
• Buffy Spencer
• Dwanali Sperman, MS, OTR/L
• St John's Regional Health Center (St John's Pharmacy-Nixa)
• St. John's Clinic, Inc.
• Crystal Stapp
• Christine Maria Starnes, RN, BSN, IBCLC
• Jaelin Rose Staus, PHARMD

• Professional Counselor in Nixa, MO
• Providers in Nixa, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.