Active NPI
Pamela Wine
- Professional Counselor
- Blue Springs, MO
National Provider Identifier
1740932557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2002004636
- Practice address
- 9024 SE 1St Street CT
Blue Springs, MO 64064-8017 - Phone
- (816) 878-1455
- NPI assigned
- Jan 23, 2022
- 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 | 2002004636 | MO | Primary |
Addresses
Primary practice location
9024 SE 1St Street CT
Blue Springs, MO 64064-8017
Mailing address
9024 SE 1St Street CT
Blue Springs, MO 64064-8017
Phone (816) 878-1455
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2002004636 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642896000000",
"number": "1740932557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9024 SE 1ST STREET CT",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640648017",
"telephone_number": "816-878-1455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9024 SE 1ST STREET CT",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640648017",
"telephone_number": "816-878-1455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINE",
"first_name": "PAMELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-23",
"last_updated": "2022-01-23",
"certification_date": "2022-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2002004636",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.