Dede Carson, MAADCII
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Aurora, MO
NPI 1982245825 · NPPES record last updated Oct 2, 2019
Key facts
- NPI
- 1982245825
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 9512 (MO)
- Practice address
- 1401 S Elliott Ave
Aurora, MO 65605-2103 - Phone
- (417) 671-9856
- NPI assigned
- Oct 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240313000638 | MO | Practitioner - Clinical Social Worker | 4587820063 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9512 | MO | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Counseling and Therapeutic Services, LLC | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Center for Life Coaching and Counseling, LLC | Current |
Accepting new patients |
Locations
1401 S Elliott Ave
Aurora, MO 65605
Phone (417) 671-9856
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9512 | MO | Yes |
Addresses
Primary practice location
1401 S Elliott Ave
Aurora, MO 65605-2103
Mailing address
1305 Brookside LN
Aurora, MO 65605-8158
Phone (417) 569-2143
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | centerforlifecoachingandcounselling.com | Health Information Exchange (HIE) |
Other providers in Aurora, MO
- Brian D. Petrovich, PSYD, LPC, LLC
- Bristol Care, Inc.
- Carolyn Ann Broyles
- BT Acquisitions, LLC
- Christopher Shane Bunn
- Judy Loraine Carver
- Center for Counseling and Therapeutic Services, LLC
- Center for Life Coaching and Counseling, LLC
- Charles L.. Chambers
- Children'S Smile Center
All providers in Aurora, MO · Addiction (Substance Use Disorder) Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.