Provider Demographics
NPI:1215987219
Name:SEXTON, MICHAEL PAUL (LPC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PAUL
Last Name:SEXTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3503 N BOBOLINK DR
Mailing Address - Street 2:PO BOX 430
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-6214
Mailing Address - Country:US
Mailing Address - Phone:417-224-4752
Mailing Address - Fax:417-581-0438
Practice Address - Street 1:3503 N BOBOLINK DR
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721
Practice Address - Country:US
Practice Address - Phone:417-224-4752
Practice Address - Fax:417-581-0438
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999137155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional