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Individual

MARY A COUCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS,LPC

Contact information

Practice address
630 W KEARNEY ST, SPRINGFIELD, MO 65803-2508
(417) 761-5000
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2019031359
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000
CAQH
MO
05
490074332
MO
Enumeration date
05/16/2019
Last updated
04/29/2026
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