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NPI Code Detail

MEDICARE: MR. JAMES MARSHALL CHILDERS LCPC

MEDICARE: MR. JAMES MARSHALL CHILDERS LCPC
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 Counselor03002KS
2101YP2500XProfessional Counselor6791OK
3101YP2500XProfessional Counselor2007034754MO

General Provider Information

NPI Number : 1487890539
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES MARSHALL CHILDERS LCPC
Provider Business Mailing Address
First Line : 2808 S PICHER AVE
Second Line :
City : JOPLIN
State : MO
Zip : 64804-1645
Country : US
Telephone Number : 417-347-7700
Fax Number :
Provider Business Practice Location Address
First Line : 810 CEDAR ST
Second Line :
City : GIRARD
State : KS
Zip : 66743-2056
Country : US
Telephone Number : 620-724-8806
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2008
Last Update Date : 03/14/2022

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Directions to “ MR. JAMES MARSHALL CHILDERS LCPC” Practice Location

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