Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1073981064 Individual Practitioner Male Practitioner

Kyle Watson , LPC

Counselor - Professional • Springfield, MO

Professional Overview & Biography Verified Profile Summary

Kyle Watson, LPC is a registered healthcare professional specializing in Counselor - Professional in Springfield, MO. Practice services are available at 1505 E BRADFORD PKWY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1505 E Bradford Pkwy

Springfield, MO 658046566

Telephone 4173226622
Fax 4173501935
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Springfield, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.9 Yrs
State Avg: 13.5 Yrs
Regional Practice Density
664 Specialists

Practicing in Springfield, MO (5929 Statewide)

Telehealth Adoption Rate
2.3% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-03-01
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MO 2015031019

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
830101319 (MO)

Secondary Practice Locations

5548 N Farmer Branch Rd

Ozark, MO 657215315

Phone: 4173226622

3600 S National Ave

Springfield, MO 658077311

Phone: 4173226622

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

25 Associated Practitioners
James Carpenter , LPC

Counselor - Professional

NPI 1013655943

Licensed Professional Counselor

Dr. Stephanie Wells , DNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1043820681

Doctor of Nursing Practice

Amanda Wilson , APRN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1134852817

Advanced Practice Registered Nurse

Sheila Fomenky

Nurse Practitioner - Psychiatric/Mental Health

NPI 1144709247
Makayla Macdonald

Counselor - Professional

NPI 1194211896
Kevin Lane , MS, LPC

Counselor - Professional

NPI 1215281894

Master of Science, Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location March 01, 2023

Registered at 1505 E BRADFORD PKWY, SPRINGFIELD, MO 658046566 (Tel: 4173226622)

📍
Updated Practice Location October 08, 2021

Registered at 3100 S NATIONAL AVE STE 103, SPRINGFIELD, MO 658077347 (Tel: 4173226622)

📍
Updated Business Mailing Address October 08, 2021

Registered at 3600 S NATIONAL AVE, SPRINGFIELD, MO 658077311 (Tel: 4173226622)

📍
Updated Practice Location August 09, 2018

Registered at 1430 OLIVE ST STE 500, SAINT LOUIS, MO 63103 (Tel: 3142063700)

📍
Updated Business Mailing Address August 09, 2018

Registered at 1430 OLIVE ST STE 400, SAINT LOUIS, MO 631032303 (Tel: 3142063700)

👤
Provider Name / Credentials Updated August 09, 2018

Recorded as KYLE WATSON, LPC

NPI Profile Active September 08, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location September 08, 2015

Registered at 3050 S NATIONAL AVE STE 104, SPRINGFIELD, MO 658044242 (Tel: 4175974572)

📍
Updated Business Mailing Address September 08, 2015

Registered at 3050 S NATIONAL AVE STE 104, SPRINGFIELD, MO 658044242 (Tel: 4175974572)

👤
Provider Name / Credentials Updated September 08, 2015

Recorded as KYLE WATSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 08, 2015

Counselor (License #2015031019 in MO)

🟢
Initial NPI Registration & Enumeration September 08, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1073981064
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 08, 2015
Last Update: March 01, 2023
Sole Proprietor: Yes

Mailing Address

3600 S National Ave

Springfield, MO 658077311

Phone: 4173226622

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.