Provider Demographics
NPI:1346720687
Name:COMER COUNSELING AND ASSOCIATES
Entity Type:Organization
Organization Name:COMER COUNSELING AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHALA
Authorized Official - Middle Name:PAIGE
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:660-909-1748
Mailing Address - Street 1:117 SE 591ST RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-9368
Mailing Address - Country:US
Mailing Address - Phone:660-909-1748
Mailing Address - Fax:660-362-1332
Practice Address - Street 1:598 SE DD HWY STE 1
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-8406
Practice Address - Country:US
Practice Address - Phone:660-909-1748
Practice Address - Fax:660-362-1332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0Medicaid