Active NPI
Jacqueline S. Welborn, MA, PLPC, CSACII
- Professional Counselor
- Waynesville, MO
National Provider Identifier
1740309129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2007008181
- Practice address
- 107 Historic 66 E
Waynesville, MO 65583-2643 - Phone
- (573) 528-1292
- Fax
- (888) 554-6133
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2007008181 | MO | Primary |
Addresses
Primary practice location
107 Historic 66 E
Waynesville, MO 65583-2643
Mailing address
901 N Pine St
Suite 101
Rolla, MO 65401-3141
Phone (573) 426-2588
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007008181 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202428800000",
"number": "1740309129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 N PINE ST",
"address_2": "SUITE 101",
"city": "ROLLA",
"state": "MO",
"postal_code": "654013141",
"telephone_number": "573-426-2588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 HISTORIC 66 E",
"city": "WAYNESVILLE",
"state": "MO",
"postal_code": "655832643",
"telephone_number": "573-528-1292",
"fax_number": "888-554-6133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELBORN",
"first_name": "JACQUELINE",
"middle_name": "S.",
"name_prefix": "Ms.",
"credential": "MA, PLPC, CSACII",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2008-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2007008181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waynesville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.