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NPI Code Detail

MEDICARE: MARY A INGRASSIA-PAYAN ROSALES MS, PLPC

MEDICARE: MARY A INGRASSIA-PAYAN ROSALES MS, PLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2026013686MO

General Provider Information

NPI Number : 1861185431
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY A INGRASSIA-PAYAN ROSALES MS, PLPC
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5214
Fax Number : 417-761-5065
Provider Business Practice Location Address
First Line : 1300 E BRADFORD PKWY BLDG B
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2023
Last Update Date : 04/06/2026

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