MEDICARE: MR. DAVID L CULBERT MA, CADC, LPC

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	101YP2500X	Professional Counselor	2004008723	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3000	OTHER	MO	CSAC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841230901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID L CULBERT MA, CADC, LPC

Provider Business Mailing Address
First Line	:	2032 E KEARNEY ST
Second Line	:	SUITE 201
City	:	SPRINGFIELD
State	:	MO
Zip	:	65803-4610
Country	:	US
Telephone Number	:	417-848-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2032 E KEARNEY ST
Second Line	:	SUITE 201
City	:	SPRINGFIELD
State	:	MO
Zip	:	65803-4610
Country	:	US
Telephone Number	:	417-848-4900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	05/02/2011

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