Kelley M Snow Watson, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2014029820 Issued in MO

Practice address

3600 S National Ave
Springfield, MO 65807-7311

Phone

(417) 322-6622

Fax

(417) 350-1935

NPI assigned

Aug 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Eustasis Foundation, Inc

  • Voluntary or Charitable Agency
  • Springfield, MO
  • NPI 1386257780
  NPD (past)
• Honour Brite LLC

  dba Eustasis Psychiatric and Addiction Health

  • Multi-Specialty Clinic/Center
  • Springfield, MO
  • NPI 1548760820
  NPD (past)

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1972902211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077311",
            "telephone_number": "417-322-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077311",
            "telephone_number": "417-322-6622",
            "fax_number": "417-350-1935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 S National Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658077347",
            "country_code": "US",
            "telephone_number": "417-322-6622",
            "fax_number": "417-350-1935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SNOW WATSON",
        "first_name": "KELLEY",
        "middle_name": "M",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2014029820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "490016414",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Nicole Snider, D.O.
• Nolan C. Snider, MD
• Rebekah Lynn Snider, NP
• Alexa Renee Snodgrass
• Derek Lee Snodgrass
• Jon F Snow, MD
• Jayelee Snowden, LPC
• Kristen Ruth Snyder-Hernandez, MD
• Christina Snyder, DNP, APRN, FNP-C
• Christopher H. Snyder Jr., MD

• Professional Counselor in Springfield, MO
• Providers in Springfield, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.