Organization
COUNSELING ASSOCIATES OF THE FOUR STATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB RUSSELL CONKLIN LPC (OWNER, LPC)
(417) 627-9994
Entity
Organization
Contact information
Practice address
705 W 26TH ST, JOPLIN, MO 64804-1904
(417) 627-9994
(417) 627-9995
Mailing address
705 W 26TH ST, JOPLIN, MO 64804-1904
(417) 627-9994
(417) 627-9995
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/12/2009
Last updated
11/11/2025
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