National Provider Identifier Database

NICOLE COSTELLO, MS.PSY,CRADC,MOUD,CS – NPI #1013526318
Community/Behavioral Health

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.


Contact Information

NICOLE COSTELLO, MS.PSY,CRADC,MOUD,CS
2919 E 4TH ST
CORPORATE HOME BASE ASSIGNMENT
JOPLIN, MO64801-1625
Phone: 417-782-7966
Fax: 417-624-4558
Website:
Specialty Taxonomy Code
* Community/Behavioral Health 251S00000X
Addiction (Substance Use Disorder) 101YA0400X
Adult Mental Health 261QM0850X
Case Manager/Care Coordinator 171M00000X
Methadone 261QM2800X
Technician, Health Information 247000000X

* Indicates primary specialty

NPI Profile & details for NICOLE COSTELLO

NPI Number 1013526318
Credentials MS.PSY,CRADC,MOUD,CS
Entity Individual
Enumeration date 07/23/2020
Last updated 01/07/2026 - About 5 months ago
Sole proprietor1 Yes
Identifiers
  • MO License #: 14770
  • MO License #: 1922
  • OR License #: 93-6002307
  • OR Medicaid: 122994
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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