MR. DOUGLAS EDWARD SPROUSE MASTERS IN SOCIAL WO NPI 1790837805

NPI Information

NPI: 1790837805
Provider Name: MR. DOUGLAS EDWARD SPROUSE, MASTERS IN SOCIAL WO
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3805 OAKLAND AVENUE
SUITE 102F
SAINT JOSEPH, MO
ZIP 64506
Phone: (816) 671-9604
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MR. Douglas Edward Sprouse, MASTERS IN SOCIAL WO is an addiction (substance use disorder) counselor in Saint Joseph, MO. MR. Douglas Edward Sprouse, MASTERS IN SOCIAL WO NPI is 1790837805. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3805 OAKLAND AVENUE
SUITE 102F
SAINT JOSEPH, MO
ZIP 64506
Phone: (816) 671-9604
Fax: (816) 364-2158

The enumeration date for this NPI number is 1/17/2007 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	365	MISSOURI	Yes
2	1041C0700X	Social Worker	Clinical	001033	MISSOURI	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	19706028	OTHER		BLUE CROSS BLUE SHIELD
2	R30671	MEDICARE ID-TYPE UNSPECIFIED	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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