Individual provider Active NPI

Julie Costello, LCMFT

  • Marriage & Family Therapist
  • Pittsburg, KS
National Provider Identifier
1861761462
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2875 Issued in KS
Practice address
2809 N Broadway St Ste E
Pittsburg, KS 66762-2684
Phone
(620) 644-3013
NPI assigned
Dec 28, 2011
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2018038211 MO
Marriage & Family Therapist 106H00000X MFT001291 GA
Marriage & Family Therapist 106H00000X 1470 NC
Marriage & Family Therapist 106H00000X 2875 KS Primary

Addresses

Primary practice location

2809 N Broadway St Ste E
Pittsburg, KS 66762-2684

Mailing address

2809 N Broadway St Ste E
Pittsburg, KS 66762-2684
Phone (620) 644-3013

Other identifiers 1

IdentifierTypeStateIssuer
12432779OtherCAQH PROVIDER NUMBER

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

LicenseStateTypeSpecialty
MFT001291GAMDMarriage & Family Therapist
2018038211MOMDMarriage & Family Therapist
1470NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Got Your Six Counseling, LLC Current Accepting new patients

Locations

2809 N Broadway St
Ste E
Pittsburg, KS 66762
Phone (620) 232-3600

702 N Locust St
Unit 1623
Pittsburg, KS 66762

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1325030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1861761462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 N BROADWAY ST STE E",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622684",
            "telephone_number": "620-644-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 N BROADWAY ST STE E",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667622684",
            "telephone_number": "620-644-3013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "JULIE",
        "name_prefix": "Dr.",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-28",
        "last_updated": "2022-02-11",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MO",
            "license": "2018038211",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001291",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1470",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "2875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "12432779",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.

Verify at the official NPI Registry.