David Wayne Costello, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2011041274 Issued in MO

Practice address

777 E Battlefield St
Suite 102B
Springfield, MO 65807-4807

Phone

(417) 597-4572

NPI assigned

Dec 25, 2011

Last updated

Dec 25, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Compass Counseling Services, LLC

  • Professional Counselor
  • Springfield, MO
  • NPI 1194042002
  NPD (past)
• Compass Counselling Services

  • Community/Behavioral Health Agency
  • Springfield, MO
  • NPI 1093091514
  NPD (past)

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

{
    "created_epoch": "1324771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324771200000",
    "number": "1811266505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 E 10TH ST",
            "city": "PLANKINTON",
            "state": "SD",
            "postal_code": "573682056",
            "telephone_number": "417-894-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E BATTLEFIELD ST",
            "address_2": "SUITE 102B",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658074807",
            "telephone_number": "417-597-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-25",
        "last_updated": "2011-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2011041274",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "2915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Chawntay Coryell, RPH
• Costco Wholesale Corporation (Costco Hearing Aid #1486)
• Costco Wholesale Corporation (Costco Optical #1486)
• Costco Wholesale Corporation (Costco Pharmacy #1486)
• Cortney Ann Costello, LPC, NCC
• Kimberly Costello
• Tiffany Costello, PLPC
• Jill Cotner
• Kayla Cotter
• Michael D Cotter, MS, LPC

• Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.