COUNSELING ASSOCIATES OF THE FOUR STATES, LLC – Mental Health Counselor, NPI 1023255106

COUNSELING ASSOCIATES OF THE FOUR STATES, LLC is a healthcare provider. based in Joplin, Missouri. specializing in Mental Health Counselor. The organization holds a License No. 2008036432 (MO). The NPI Number for COUNSELING ASSOCIATES OF THE FOUR STATES, LLC is 1023255106

Main info

Organization
Name
COUNSELING ASSOCIATES OF THE FOUR STATES, LLC
NPI
1023255106
Phone
(417) 627-9994
Address
705 ILLINOIS AVE
Authorized Official
JACOB RUSSELL CONKLIN OWNER, LPC LPC
Enumeration Date
12 January 2009
Last Update Date
11 November 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness85
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for COUNSELING ASSOCIATES OF THE FOUR STATES, LLC

  • 705, Illinois Avenue, Joplin, Jasper County, Missouri, 64801, United States

    STE 22

    JOPLIN, MO 648015067

    Phone: (417) 627-9994

    Fax: (417) 627-9995

    Type: Mailing

  • 705 W 26TH ST

    JOPLIN, MO 648041904

    Phone: (417) 627-9994

    Fax: (417) 627-9995

    Type: Mailing

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: 2013-01-16

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
O20130116000208OClinic/Group PracticeMOTBD

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 64801)

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Reviews

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Frequently asked questions

How do I look up COUNSELING ASSOCIATES OF THE FOUR STATES, LLC by NPI?
Use NPI 1023255106 when you need to reference COUNSELING ASSOCIATES OF THE FOUR STATES, LLC in forms, claims, or directories.
Is COUNSELING ASSOCIATES OF THE FOUR STATES, LLC's NPI currently valid?
The extract we use shows COUNSELING ASSOCIATES OF THE FOUR STATES, LLC as active.
What does COUNSELING ASSOCIATES OF THE FOUR STATES, LLC treat or focus on?
Patients typically see COUNSELING ASSOCIATES OF THE FOUR STATES, LLC under the specialty Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location shows for COUNSELING ASSOCIATES OF THE FOUR STATES, LLC?
We surface Joplin, Missouri for COUNSELING ASSOCIATES OF THE FOUR STATES, LLC based on available NPPES addresses.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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