Healthcare Provider Details

I. General information

NPI: 1821240789
Provider Name (Legal Business Name): REED BRIGHTON BISSO M.A. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AMANDA BISSO

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1059 BARTON DR
FORDLAND MO
65652-7350
US

IV. Provider business mailing address

1059 BARTON DR
FORDLAND MO
65652-7350
US

V. Phone/Fax

Practice location:
  • Phone: 417-767-2273
  • Fax: 417-767-4054
Mailing address:
  • Phone: 417-767-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2018001147
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: