ETHAN BLAIR (MA, PLPC) – Counselor, NPI 1194402586

ETHAN BLAIR (MA, PLPC) is a healthcare provider. based in Saint joseph, Missouri. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, PLPC. They hold a License No. 2023025977 (MO). The NPI Number for ETHAN BLAIR (MA, PLPC) is 1194402586

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
ETHAN BLAIR (MA, PLPC)
NPI
1194402586
Phone
(816) 341-1501
Address
724 N 22ND ST
Enumeration Date
28 June 2023
Last Update Date
28 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8163641501
Graduation Year
2022 (4 years ago)
PAC ID
7517449499
Group Practice PAC ID
6800707571
Professional Enrollment ID
I20260302000957
Address ID
MO645062604SA724XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,232 MENTAL HEALTH COUNSELOR in MO

Provider Addresses for ETHAN BLAIR (MA, PLPC)

  • 724 N 22ND ST

    SAINT JOSEPH, MO 645062604

    Phone: (816) 341-1501

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-03-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20260302000957IMental Health CounselorMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64506)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800707571View full group profile
NameSpecialtyState
Nurse PractitionerMO
P S Y C H I A T R YMO
Mental Health CounselorMO
Clinical Social WorkerMO
Clinical Social WorkerMO
Clinical Social WorkerMO
Nurse PractitionerMO
Clinical Social WorkerMO
Clinical Social WorkerMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

Is ETHAN BLAIR (MA, PLPC) listed with a National Provider Identifier?
Yes — ETHAN BLAIR (MA, PLPC) has NPI 1194402586 on file in the registry.
Would ETHAN BLAIR (MA, PLPC) appear as active to a payer?
You can treat ETHAN BLAIR (MA, PLPC) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is ETHAN BLAIR (MA, PLPC)?
ETHAN BLAIR (MA, PLPC) is associated with Counselor in the directory — Clinical services aligned with this taxonomy classification.
Is ETHAN BLAIR (MA, PLPC) located near Saint Joseph?
ETHAN BLAIR (MA, PLPC) currently maps to Saint Joseph, Missouri in this extract.
Does ETHAN BLAIR (MA, PLPC) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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