Mark B Stevens, PSYD

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2002010324 Issued in MO

Practice address

1197 Highway KK
Osage Beach, MO 65065-3344

Phone

(573) 348-5331

Fax

(573) 348-5232

NPI assigned

Jan 10, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Wellness, LLCGroup PAC ID 5395742316, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mental Wellness, LLC

  • Clinical Psychologist
  • Osage Beach, MO
  • NPI 1639254600
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740269604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 925",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650650925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1197 HIGHWAY KK",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653344",
            "telephone_number": "573-348-5331",
            "fax_number": "573-348-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MARK",
        "middle_name": "B",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2002010324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harjyot S Sohal, MD
• Philip Hyun Son, DMD
• Cathy A Spetek, RD LD
• Brenda Renee Spies, PHARM D.
• Springfield Neurological and Spine Institute
• Brooke Elizabeth Stone, COTA/L
• Tasha Stuckenschneider
• Lee Supitilov
• William Supitilov
• Surgical Institute of Lake of the Ozarks LLC

• Counselor in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.