Provider Demographics
NPI:1992327001
Name:SPERO COUNSELING CENTER, LLC
Entity type:Organization
Organization Name:SPERO COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROETTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:417-893-9359
Mailing Address - Street 1:3101 S KIMBROUGH AVE # B
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-5011
Mailing Address - Country:US
Mailing Address - Phone:417-893-9359
Mailing Address - Fax:417-450-4896
Practice Address - Street 1:3101 S KIMBROUGH AVE # B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5011
Practice Address - Country:US
Practice Address - Phone:417-893-9259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1285145730Medicaid