Active NPI
Bobbie Sue Wood
- Professional Counselor
- Poplar Bluff, MO
National Provider Identifier
1902564156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2021018564
- Practice address
- 2995 Warrior LN
Poplar Bluff, MO 63901-8600 - Phone
- (573) 712-2902
- NPI assigned
- Dec 6, 2021
- Last updated
- Jul 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2021018564 | MO | Primary |
Addresses
Primary practice location
2995 Warrior LN
Poplar Bluff, MO 63901-8600
Mailing address
2995 Warrior LN
Poplar Bluff, MO 63901-8600
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1902564156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2995 WARRIOR LN",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639018600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2995 WARRIOR LN",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639018600",
"telephone_number": "573-712-2902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "BOBBIE",
"middle_name": "SUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-06",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2021018564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poplar Bluff, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.