MEDICARE: FAMILY COUNSELING CENTER OF MISSOURI, INC.

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
1	101Y00000X	Counselor
2	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649269622	OTHER	MO	FCCMO BILLING NPI NUMBER

General Provider Information

NPI Number	:	1538204904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY COUNSELING CENTER OF MISSOURI, INC.

Provider Business Mailing Address
First Line	:	117 N GARTH AVE
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-4103
Country	:	US
Telephone Number	:	573-443-2204
Fax Number	:	573-875-6607

Provider Business Practice Location Address
First Line	:	15899 LOGANS LAKE RD
Second Line	:	#A
City	:	BOONVILLE
State	:	MO
Zip	:	65233-2866
Country	:	US
Telephone Number	:	660-882-2333
Fax Number	:	660-882-2333

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. ALLEN TACKER
Credential	:	PH.D.
Telephone Number	:	573-443-2204

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

1902806581 — PHYLLIS M REESMAN LCSW
Practice Location Address:

15899 LOGANS LAKE RD
BOONVILLE, MO
65233-2866

Practice Phone: 660-882-2333
Practice Fax: 550-882-2333

1891758736 — MRS. MONIQUE F SCHRADER MALPC
Practice Location Address:

15899 LOGANS LAKE RD
BOONVILLE, MO
65233-2866

Practice Phone: 660-882-2333
Practice Fax: 660-882-2333

1891790291 — MRS. JENNIFER JO HACKMAN P.T. ,A.T.C.
Practice Location Address:

1420 W ASHLEY RD
BOONVILLE, MO
65233-2112

Practice Phone: 660-882-6115
Practice Fax: 660-882-6120

1003811258 — MISS KELLEY NICOLE TATE P.T.
Practice Location Address:

1420 W ASHLEY RD
BOONVILLE, MO
65233-2112

Practice Phone: 660-882-6115
Practice Fax: 660-882-6120

1427057793 — DR. JOHN MICHAEL WARD D.O.
Practice Location Address:

306 MAIN ST
BOONVILLE, MO
65233-1566

Practice Phone: 660-882-2451
Practice Fax: 660-882-2434

1790777191 — JEFF BIRDSONG O.D.
Practice Location Address:

505 E WALNUT ST
BOONVILLE, MO
65233-1665

Practice Phone: 660-882-2444
Practice Fax: 660-882-7976

Directions to “FAMILY COUNSELING CENTER OF MISSOURI, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.