Faith Counseling, LLC
Organization Active NPI Counselor · Salem, MO
NPI 1770189581 · NPPES record last updated Dec 7, 2020
Key facts
- NPI
- 1770189581
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- FAITH COUNSELING, LLC
- Practice address
- 119 W 4TH St
Salem, MO 65560-1255 - Phone
- (573) 247-6086
- NPI assigned
- Dec 7, 2020
- Organization subpart
- No
Authorized official
- Name
- Kimberely Ingram, LPC
- Title
- Licensed Professional Counselor
- Phone
- (573) 247-6086
Practitioners 1
-
Kimberely L Ingram, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240320000113 | MO | Part B Supplier - Clinic/Group Practice | 1759728249 |
Receives reassigned benefits from 1 practitioner Practice locations: Salem, MO |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes |
Addresses
Primary practice location
119 W 4TH St
Salem, MO 65560-1255
Mailing address
904 County Road 2270
Salem, MO 65560-7923
Phone (573) 247-6086
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 495023707 | Medicaid | MO |
Other providers in Salem, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2020. 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.