Healthcare Provider Details

I. General information

NPI: 1073286803
Provider Name (Legal Business Name): DANA FLEMING COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 W MAIN ST
WEST PLAINS MO
65775-2732
US

IV. Provider business mailing address

PO BOX 1475
WEST PLAINS MO
65775-1475
US

V. Phone/Fax

Practice location:
  • Phone: 417-553-1242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANA FLEMING
Title or Position: MANAGER
Credential:
Phone: 417-989-9287