MEDICARE: PEMBERTON COUNSELING LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1851243596
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEMBERTON COUNSELING LLC

Provider Business Mailing Address
First Line	:	2804 FORUM BLVD STE 3A
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-6661
Country	:	US
Telephone Number	:	573-446-6290
Fax Number	:

Provider Business Practice Location Address
First Line	:	2804 FORUM BLVD STE 3A
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-6661
Country	:	US
Telephone Number	:	573-446-6290
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MORGAN PEMBERTON
Credential	:	LPC
Telephone Number	:	573-446-6290

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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