Phoebe G Fullen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1701 N Central Ave
Monett, MO 65708

Phone

(417) 236-0340

NPI assigned

Aug 28, 2019

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Female

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clark Community Mental Health Center

  • Community/Behavioral Health Agency
  • Monett, MO
  • NPI 1801807771

  Mental Health

  Medicare reassignment NPD
• Yco Tulsa, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lawton, OK
  • NPI 1629400288
  NPD (past)

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1740838259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 SW C AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735014311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N CENTRAL AVE",
            "city": "MONETT",
            "state": "MO",
            "postal_code": "65708",
            "telephone_number": "417-236-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLEN",
        "first_name": "PHOEBE",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Forest, COTA/L
• Adam Forrest, LPC
• James C. Frazier II, MD
• Scott Freeland, M.D.
• Kelly Frey, PLPC
• Jessica Gilkey, RD, LD/N
• Michael Paul Glouse, DDS
• GMT Family Enterprise, Inc
• Sierra Golubski
• William W. Goodman III, MD

• Mental Health Counselor in Monett, MO
• Providers in Monett, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.