| Black Hawk-grundy Mental Health Center Inc. | |
|
3251 W 9th St Waterloo IA 50702-5310 | |
| (319) 234-2893 | |
| (319) 234-0354 |
| Full Name | Black Hawk-grundy Mental Health Center Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3251 W 9th St, Waterloo, Iowa |
| Authorized Official Name and Position | Thomas Charles Eachus (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3192342893 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hawk-grundy Mental Health Center Inc. 3251 W 9th St Waterloo IA 50702-5310 Ph: (319) 234-2893 | Black Hawk-grundy Mental Health Center Inc. 3251 W 9th St Waterloo IA 50702-5310 Ph: (319) 234-2893 |
| NPI Number | 1316944598 |
|---|---|
| Provider Enumeration Date | 07/05/2005 |
| Last Update Date | 06/19/2017 |
| Medicare PECOS PAC ID | 1850280363 |
|---|---|
| Medicare Enrollment ID | O20040312000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316944598 | NPI | - | NPPES |
| 0074435 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joyce M Andresen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538314018 PECOS PAC ID: 9739236027 Enrollment ID: I20090402000024 |
| Provider Name | Connie L Popenhagen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669662854 PECOS PAC ID: 3678611258 Enrollment ID: I20091119000344 |
| Provider Name | Patricia A Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417037086 PECOS PAC ID: 1052436425 Enrollment ID: I20100909000413 |
| Provider Name | Thomas C Eachus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518048537 PECOS PAC ID: 6002705514 Enrollment ID: I20100909000447 |
| Provider Name | Jamey L Gregersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164823092 PECOS PAC ID: 1355561747 Enrollment ID: I20141007001731 |
| Provider Name | Donna R Dobson Tobin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245227099 PECOS PAC ID: 6103842968 Enrollment ID: I20150407001355 |
| Provider Name | Melissa S Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164872735 PECOS PAC ID: 3476816422 Enrollment ID: I20180404002467 |
| Provider Name | Nicole M Delagardelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255823506 PECOS PAC ID: 5991053183 Enrollment ID: I20180803001777 |
| Provider Name | Tenaea M Jeppeson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043703887 PECOS PAC ID: 7517216187 Enrollment ID: I20180815003565 |
| Provider Name | Alyssa K Fruchtenicht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639511710 PECOS PAC ID: 5799034013 Enrollment ID: I20180821000323 |
| Provider Name | Stephanie Anne Giesler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750845954 PECOS PAC ID: 3274860754 Enrollment ID: I20190806002737 |
| Provider Name | Emily Swartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417523192 PECOS PAC ID: 8820490972 Enrollment ID: I20210712002625 |
| Provider Name | Kathleen Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124692553 PECOS PAC ID: 8325441462 Enrollment ID: I20210727001004 |
| Provider Name | Kama Sarah Ausborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669056123 PECOS PAC ID: 9133523517 Enrollment ID: I20210810003396 |
| Provider Name | Manraj Padda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376020933 PECOS PAC ID: 4082965405 Enrollment ID: I20220628000304 |
| Provider Name | Abby Irene Kolthoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184056822 PECOS PAC ID: 1254796881 Enrollment ID: I20230503001497 |
| Provider Name | Abigail M Rickert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295380061 PECOS PAC ID: 1759722622 Enrollment ID: I20240509000367 |
| Provider Name | Adarienne Lynne Burrow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679926067 PECOS PAC ID: 3072955913 Enrollment ID: I20240523003395 |
Pathways Behavioral Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3362 University Ave, Waterloo, IA 50701 Phone: 319-235-6571 Fax: 319-235-6028 | |
New Start Behavioral Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 E 4th Street,, Waterloo, IA 50703 Phone: 319-493-5120 | |
Cedar Valley Center For Expressive Arts Therapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Sycamore St, Waterloo, IA 50703 Phone: 319-888-1022 | |
Veridian Fiscal Solutions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 Fisher Dr, Waterloo, IA 50701 Phone: 855-828-0775 | |
Veridian Fiscal Solutions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 Fisher Dr, Waterloo, IA 50701 Phone: 855-828-0775 | |
Change Behavioral Health, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 Sycamore St Ste 623, Waterloo, IA 50703 Phone: 319-233-0323 Fax: 319-233-5923 | |
Hope Tree Counseling Services Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1420 W Donald St, Waterloo, IA 50703 Phone: 319-232-4673 |