EAGLE CREST COUNSELING CENTER INC. NPI 1659421931

NPI Information

NPI: 1659421931
Provider Name: EAGLE CREST COUNSELING CENTER, INC.
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
636 W REPUBLIC RD STE F100
SPRINGFIELD, MO
ZIP 65807
Phone: (417) 862-8282
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EAGLE CREST COUNSELING CENTER, INC. is a mental health (including community mental health center) clinic center in Springfield, MO. EAGLE CREST COUNSELING CENTER, INC. NPI is 1659421931. The provider is registered as an organization entity type.

The provider's business location address is:

636 W REPUBLIC RD STE F100
SPRINGFIELD, MO
ZIP 65807-810
Phone: (417) 862-8282
Fax: (417) 862-8805

The provider's authorized official is Jim W. Cherry .
The authorized official title is Office Manager and has the following contact phone number (417) 862-8282.

The enumeration date for this NPI number is 1/11/2007 and was last updated on 3/1/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500792502	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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