SUCCESS HEALTH SYSTEM, LLC – Mental Health Counselor, NPI 1508310293
Mental Health Counselor
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SUCCESS HEALTH SYSTEM, LLC
2010 S Buckner Blvd
Dallas, TX 752171804
Phone: (888) 410-5230
Type: Location
2805 E 19th St
Vancouver, WA 986614614
Phone: (888) 410-5230
Type: Location
607, Teaco Road, Kennett, Dunklin County, Missouri, 63857, United States
KENNETT, MO 638573723
Phone: (972) 974-0109
Fax: (573) 271-5108
Type: Location
11695 S Blackbob Rd
Olathe, KS 660621058
Phone: (888) 410-5230
Type: Location
4429 S River Blvd Ste D
Independence, MO 640554659
Phone: (888) 410-5230
Type: Location
12401 Olive Blvd Ste 206
Creve Coeur, MO 631415448
Phone: (888) 410-5230
Type: Location
3400 Chapel Hill Rd
Douglasville, GA 301351739
Phone: (888) 410-5230
Type: Location
716, Gage Road, Ilion, Town of Columbia, Herkimer County, New York, 13357, United States
COLUMBIA, MO 652050716
Phone: (972) 974-0109
Fax: (573) 271-5108
Type: Mailing
3600 INTERSTATE 70 DR SE STE C
COLUMBIA, MO 652016583
Phone: (888) 410-5230
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: 2024-07-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-01-31 (862 days ago).
Enrollment records
4
Earliest due date
2024-01-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170316000937 | O | Clinic/Group Practice | MO | TBD |
| O20170526001310 | O | Clinic/Group Practice | KS | 2024-01-31 |
| O20230320001357 | O | Clinic/Group Practice | TX | TBD |
| O20240718004539 | O | Clinic/Group Practice | GA | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 75217)
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