Individual provider Active NPI

Stephanie J Costello, LPC

  • Professional Counselor
  • Rolla, MO
National Provider Identifier
1861766503
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2011039354 Issued in MO
Practice address
1450 E 10TH St
Rolla, MO 65401-3648
Phone
(888) 403-1071
NPI assigned
Feb 27, 2012
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2011039354 MO
Professional Counselor 101YP2500X 2011039354 MO Primary

Addresses

Primary practice location

1450 E 10TH St
Rolla, MO 65401-3648

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other names 1

  • Stephanie J Koxlien Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231129001280 MO Practitioner - Mental Health Counselor 9335597558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Health IncGroup PAC ID 1951206754, 317 clinicians

Practice addresses (Care Compare)

1450 E 10TH St
Rolla, MO 65401-3648
Phone (888) 403-1071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011039354MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jan 1, 2024 Accepting new patients
Compass Health, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

1448 E 10th St
Rolla, MO 65401
Phone (660) 207-7273

1450 E 10th St
Rolla, MO 65401
Phone (573) 364-7551

Organizations & group practices 2

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": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1861766503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E 10TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654013648",
            "telephone_number": "888-403-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-27",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2011039354",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2011039354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KOXLIEN",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rolla, MO

Sources for this page

Verify at the official NPI Registry.