SUSAN G BUCKALLEW (MED, LPC) – Professional Counselor, NPI 1386952604

SUSAN G BUCKALLEW (MED, LPC) is a healthcare provider. based in Kirksville, Missouri. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MED, LPC. They hold a License No. 2010032751 (MO). The NPI Number for SUSAN G BUCKALLEW (MED, LPC) is 1386952604

Main info

Female
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
SUSAN G BUCKALLEW (MED, LPC)
NPI
1386952604
Phone
(660) 665-1962
Address
1101 JAMISON ST
Enumeration Date
21 September 2010
Last Update Date
23 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6606651962
Graduation Year
2007 (19 years ago)
PAC ID
5395194096
Group Practice PAC ID
0244256246
Professional Enrollment ID
I20231206002972
Address ID
MO635014520KI900XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Digital endpointsOther names

1,232 MENTAL HEALTH COUNSELOR in MO

Provider Addresses for SUSAN G BUCKALLEW (MED, LPC)

  • 1101 JAMISON ST

    KIRKSVILLE, MO 635013943

    Phone: (660) 665-1962

    Fax: (660) 627-0642

    Type: Location

  • 203 E Commercial St

    Kahoka, MO 634451710

    Phone: (660) 727-1111

    Type: Location

  • 2015 S HALLIBURTON ST

    KIRKSVILLE, MO 635014646

    Phone: (660) 626-0698

    Type: Location

  • 1101 Jamison St

    Kirksville, MO 635013943

    Phone: (660) 665-1962

    Fax: (660) 627-0642

    Type: Location

  • 203 E COMMERCIAL ST

    KAHOKA, MO 634451710

    Phone: (660) 727-1111

    Type: Location

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: 2023-12-06

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
I20231206002972IMental 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 63501)

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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: 0244256246View full group profile
NameSpecialtyState
Mental Health CounselorOK
-OK
Mental Health CounselorMO
P S Y C H I A T R YMO
Mental Health CounselorMO
Mental Health CounselorMO
P S Y C H I A T R YMO
Mental Health CounselorMO
Mental Health CounselorMO
Nurse PractitionerMO

Reviews

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Frequently asked questions

How is SUSAN G BUCKALLEW (MED, LPC) identified in CMS data?
CMS-hosted NPPES data lists SUSAN G BUCKALLEW (MED, LPC) with NPI 1386952604.
Does the file indicate SUSAN G BUCKALLEW (MED, LPC) is practicing under active NPI?
Directory data currently reports SUSAN G BUCKALLEW (MED, LPC) as active.
What is SUSAN G BUCKALLEW (MED, LPC)'s specialty?
The listing groups SUSAN G BUCKALLEW (MED, LPC) with Professional Counselor. Clinical services aligned with this taxonomy classification.
Where should I expect SUSAN G BUCKALLEW (MED, LPC) on a map?
Expect Kirksville, Missouri as a primary anchor for SUSAN G BUCKALLEW (MED, LPC) unless the record lists multiple sites.
How many locations tie to this NPI?
6 practice locations appear in the available data.

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