Individual provider Active NPI

Magda W Romman

  • Professional Counselor
  • Springfield, MO
National Provider Identifier
1972772549
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2020043202 Issued in MO
Practice address
636 W Republic Rd Ste F100
Springfield, MO 65807-5810
Phone
(417) 866-7773
NPI assigned
Feb 27, 2008
Last updated
Jan 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2007037770 MO
Professional Counselor 101YP2500X 2020043202 MO Primary

Addresses

Primary practice location

636 W Republic Rd Ste F100
Springfield, MO 65807-5810

Mailing address

2488 S Gladia Dr
Rogersville, MO 65742-7503
Phone (417) 693-8587

Other practice location 1

1722 S Glenstone Ave
Suite TT
Springfield, MO 65804-1513
Phone (417) 881-2848

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address magda.romman@mcctherapy.com Direct

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
I20240109000238 MO Practitioner - Mental Health Counselor 8325499940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Counseling Center, Inc.Group PAC ID 9234282112, 5 clinicians

Practice addresses (Care Compare)

1864 S Kentwood Ave
Springfield, MO 65804-2323
Phone (417) 869-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007037770MOMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Crest Counseling Center, Inc. CurrentSince Jan 17, 2021 Accepting new patients
McGuire Christian Counseling Inc. CurrentSince Jan 17, 2021 Accepting new patients
Gateway Counseling Center, Inc. Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

1864 S Kentwood Ave
Springfield, MO 65804
Phone (417) 869-8400

636 W Republic Rd
Ste F100
Springfield, MO 65807
Phone (417) 862-8282

Interoperability endpoints

  • Direct secure messaging: magda.romman@mcctherapy.com

Organizations & group practices 3

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": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1972772549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2488 S GLADIA DR",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657427503",
            "telephone_number": "417-693-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 W REPUBLIC RD STE F100",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075810",
            "telephone_number": "417-866-7773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1722 S Glenstone Ave",
            "address_2": "Suite TT",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658041513",
            "country_code": "US",
            "telephone_number": "417-881-2848",
            "fax_number": "417-881-2640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMMAN",
        "first_name": "MAGDA",
        "middle_name": "W",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-27",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2007037770",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020043202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "magda.romman@mcctherapy.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "business email",
            "address_1": "636 W Republic Rd Ste F100",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658075810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.