NPIMap

Organization Active NPI

Central Methodist University

Doing business as CMU Counseling

  • Counseling Psychologist
  • Fayette, MO
National Provider Identifier
1952836645
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
2005041421 Issued in MS
Legal business name
CENTRAL METHODIST UNIVERSITY
Doing business as
CMU Counseling
Practice address
411 Central Methodist SQ
RM 206
Fayette, MO 65248-1104
Phone
(972) 367-4845
NPI assigned
May 1, 2017
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Mouzon Bass III
Title
Agent
Phone
(972) 367-4845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 2005041421 MS Primary

Addresses

Primary practice location

411 Central Methodist SQ
RM 206
Fayette, MO 65248-1104

Mailing address

5050 Spring Valley Rd
Dallas, TX 75244-3995

Other names 1

  • CMU Counseling Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Methodist University5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

411 Central Methodist Sq
Rm 206
Fayette, MO 65248

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1952836645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CENTRAL METHODIST SQ",
            "address_2": "RM 206",
            "city": "FAYETTE",
            "state": "MO",
            "postal_code": "652481104",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL METHODIST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MS",
            "license": "2005041421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMU Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayette, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.