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NPI Code Detail

MEDICARE: OAHSAH C SMALL MC

MEDICARE: OAHSAH C SMALL MC
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 Counselor2025049622MO

General Provider Information

NPI Number : 1083295836
Entity Type Code : Individual
Provider Name (Legal Business Name) : OAHSAH C SMALL MC
Provider Business Mailing Address
First Line : 207 BREWER DR
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-0201
Country : US
Telephone Number : 573-814-8240
Fax Number :
Provider Business Practice Location Address
First Line : 4304 S BEARFIELD RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-9557
Country : US
Telephone Number : 314-206-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2021
Last Update Date : 02/16/2026

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Directions to “ OAHSAH C SMALL MC” Practice Location

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