Dede Carson, MAADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

9512 Issued in MO

Practice address

1401 S Elliott Ave
Aurora, MO 65605-2103

Phone

(417) 671-9856

NPI assigned

Oct 2, 2019

Last updated

Oct 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Center for Life Coaching and Counseling, LLC

  • Community/Behavioral Health Agency
  • Aurora, MO
  • NPI 1154515153
  Medicare reassignment NPD
• Center for Counseling and Therapeutic Services, LLC

  • Community/Behavioral Health Agency
  • Aurora, MO
  • NPI 1831071554

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1982245825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 BROOKSIDE LN",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "656058158",
            "telephone_number": "417-569-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S ELLIOTT AVE",
            "city": "AURORA",
            "state": "MO",
            "postal_code": "656052103",
            "telephone_number": "417-671-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "DEDE",
        "credential": "MAADCII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MO",
            "license": "9512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "centerforlifecoachingandcounselling.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1401 S Elliott Ave",
            "city": "Aurora",
            "state": "MO",
            "country_code": "US",
            "postal_code": "656052103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian D. Petrovich, PSYD, LPC, LLC (Center for Psychological Health and Well-being)
• Bristol Care, Inc.
• Carolyn Ann Broyles, MS, LPC
• BT Acquisitions, LLC (Excel Physical Therapy)
• Christopher Shane Bunn, M.S., R.A.S.A.C II
• Judy Loraine Carver, RD,LD, CDE
• Center for Counseling and Therapeutic Services, LLC
• Center for Life Coaching and Counseling, LLC
• Charles L.. Chambers, DDS
• Children's Smile Center

• Addiction (Substance Use Disorder) Counselor in Aurora, MO
• Providers in Aurora, MO by specialty
• Addiction (Substance Use Disorder) Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.