Jessicca May Shumard, LPC
Individual provider Active NPI Professional Counselor · Jasper, MO
NPI 1801923958 · NPPES record last updated Oct 1, 2019
Key facts
- NPI
- 1801923958
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2012007230 (MO)
- Practice address
- 310 E Grand Ave
Jasper, MO 64755 - Phone
- (417) 434-3177
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012007230 | MO | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2012007230 | MO | Yes |
Addresses
Primary practice location
310 E Grand Ave
Jasper, MO 64755
Mailing address
PO Box 128
Jasper, MO 64755-0128
Phone (417) 434-3177
Other practice location 1
650 S Peoria Ave
Tulsa, OK 74120-4429
Phone (918) 560-1306
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200512160A | Medicaid | OK |
Other providers in Jasper, MO
- Rose Ann Darr
- Sadie Endicott
- Jasper County R-V School District
- Katherine Jones
- Shila Nichols
- Patricia Carol Smith
- Shelbie Spresser
- Jennifer Lynn Tucker
- Grace E Ziler
All providers in Jasper, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.