White Oak Counseling, LLC
Organization Active NPI Clinical Social Worker · Hannibal, MO
NPI 1750586103 · NPPES record last updated Jun 30, 2021
Key facts
- NPI
- 1750586103
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2004013377 (MO)
- Legal business name
- WHITE OAK COUNSELING, LLC
- Practice address
- 1221 Broadway
Hannibal, MO 63401-4005 - Phone
- (573) 221-2111
- Fax
- (573) 221-2123
- NPI assigned
- Jun 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Carrie Danner, MSW, LCSW
- Title
- Owner
- Phone
- (573) 221-2111
Practitioners 26
-
Erica Baker, MED, PLPC
-
Kara Bates, LPC, CRC
-
Carrie Eizenga Danner, MSW, LCSW
-
Peter Kilbreth Jones, LCSW, LISW, LSCSW
-
Kathy Lynn Pfaffe, LPSW, LPC, LMSW
-
Destinee Christine Lear, MSW, LMSW
-
Cynthia Anders, LPC
-
Wendy Gail Bryant, PLPC
-
Richard W Buckwalter, L.C.S.W.
-
Sara Hallberg, LPC, NCC
-
Tara Marie Huber, MSE, LPC
-
Kathleen Humphreys, MSW, PLCSW
-
Sidney M Johnson, PLPC
-
Susan Kirchner, LPCP
-
Sherry Nelson, LCSW
-
Lindsey Stewart-Montague, MS, LPC
-
Stacie Lynn Whitaker, LPC
-
Barbara Anne Geren, LISW
-
Elizabeth Ann Gibbs, PLPC
-
Kettisha M Hodges, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071213000761 | MO | Part B Supplier - Clinic/Group Practice | 3173613163 |
Receives reassigned benefits from 7 practitioners Practice locations: Hannibal, MO |
National Provider Directory
Locations
1221 Broadway
Hannibal, MO 63401
Phone (573) 221-2111
215 S Main St
Memphis, MO 63555
Phone (660) 465-4585
107 E Lafayette St
Monticello, MO 63457
Phone (573) 221-2111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | 2004013377 | MO | Yes |
Addresses
Primary practice location
1221 Broadway
Hannibal, MO 63401-4005
Mailing address
10299 Tanglewood LN
Hannibal, MO 63401-7453
Phone (573) 221-2111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 491318625 | Medicaid | MO |
Other providers in Hannibal, MO
- Geoffrey Matthew Westhoff
- Wheeler Family Home
- James N Wheeler
- Joni Gayle Wheeler
- Meghan Rhianne Wheeler
- Barbara A White
- Kristine Marie Whitehead
- Brittany Widebrook
- Judy Wilcox
- Sherri M. Wiley
All providers in Hannibal, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.