| Creative Living Center, P.c. | |
|
1905 10th St Rock Valley IA 51247-1630 | |
| (712) 476-5245 | |
| (712) 476-9621 |
| Full Name | Creative Living Center, P.c. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1905 10th St, Rock Valley, Iowa |
| Authorized Official Name and Position | Dayton J. Vogel (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7124765245 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Creative Living Center, P.c. 1905 10th St Rock Valley IA 51247-1630 Ph: (712) 476-5245 | Creative Living Center, P.c. 1905 10th St Rock Valley IA 51247-1630 Ph: (712) 476-5245 |
| NPI Number | 1609807098 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8527055714 |
|---|---|
| Medicare Enrollment ID | O20040429000156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609807098 | NPI | - | NPPES |
| 0451252 | Medicaid | IA | |
| 37804 | Other | IA | GROUP BLUE CROSS |
| Provider Name | Grace A Lafollette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659343143 PECOS PAC ID: 2769383520 Enrollment ID: I20050914000497 |
| Provider Name | Nicolette Menke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154862977 PECOS PAC ID: 9739456328 Enrollment ID: I20170602000912 |
| Provider Name | Veronica Sherwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194218966 PECOS PAC ID: 5395092472 Enrollment ID: I20181226000624 |
| Provider Name | Lauri A Wolter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740837228 PECOS PAC ID: 4880009133 Enrollment ID: I20210721001313 |
| Provider Name | Tammy Jo Vande Kamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427417898 PECOS PAC ID: 4981947595 Enrollment ID: I20220224000906 |
| Provider Name | Michael Henning |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205486685 PECOS PAC ID: 0840659272 Enrollment ID: I20230703002697 |
| Provider Name | Shawn R Scholten |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073695359 PECOS PAC ID: 4183946189 Enrollment ID: I20231122000304 |
| Provider Name | Erica Wassenaar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952713141 PECOS PAC ID: 5991153405 Enrollment ID: I20231122000345 |
| Provider Name | Dayton J Vogel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457433872 PECOS PAC ID: 3577551837 Enrollment ID: I20231122000795 |
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