Provider Demographics
NPI:1740751643
Name:WESTPHELING, DEVON E (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:DEVON
Middle Name:E
Last Name:WESTPHELING
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:E
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5349 N 22ND ST STE 7
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-6695
Mailing Address - Country:US
Mailing Address - Phone:417-319-6050
Mailing Address - Fax:417-771-3384
Practice Address - Street 1:5349 N 22ND ST STE 7
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6695
Practice Address - Country:US
Practice Address - Phone:417-319-6050
Practice Address - Fax:417-771-3384
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MO2018040816101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1234OtherCAQH