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2540 106th St Ste 101 Urbandale IA 50322-3736 | |
| (515) 949-6918 | |
| (515) 228-6341 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2540 106th St Ste 101, Urbandale, Iowa |
| Authorized Official Name and Position | Jen Haidar (OWNER) |
| Authorized Official Contact | 5159496918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2540 106th St Ste 101 Urbandale IA 50322-3736 Ph: (515) 949-6918 | 2540 106th St Ste 101 Urbandale IA 50322-3736 Ph: (515) 949-6918 |
| NPI Number | 1477719268 |
|---|---|
| Provider Enumeration Date | 08/01/2008 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Medicare PECOS PAC ID | 5890134050 |
|---|---|
| Medicare Enrollment ID | O20240419003238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477719268 | NPI | - | NPPES |
| Provider Name | Anna Johnson-schappaugh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730578840 PECOS PAC ID: 0143518225 Enrollment ID: I20200731000576 |
| Provider Name | Jenny Crone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184391278 PECOS PAC ID: 0244628287 Enrollment ID: I20211025002726 |
| Provider Name | Jennifer E Haidar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508472044 PECOS PAC ID: 7810361938 Enrollment ID: I20230313001097 |
| Provider Name | Abby Womack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265005227 PECOS PAC ID: 8820441017 Enrollment ID: I20240124000952 |
| Provider Name | Jacquelyne Renae Joens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679728679 PECOS PAC ID: 8527407600 Enrollment ID: I20240423000802 |
| Provider Name | Renae Louise Ludwig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1508194044 PECOS PAC ID: 6406296060 Enrollment ID: I20240430000606 |
| Provider Name | Rebecca S. Oconnell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1093022709 PECOS PAC ID: 3274973805 Enrollment ID: I20240430003364 |
| Provider Name | Sara J Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952657744 PECOS PAC ID: 0143661090 Enrollment ID: I20240509003137 |
| Provider Name | Gary S Selof |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1154094878 PECOS PAC ID: 3173964921 Enrollment ID: I20240511000325 |
| Provider Name | Amanda Danielle Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902501067 PECOS PAC ID: 9032653019 Enrollment ID: I20240701003981 |
| Provider Name | Samantha Brooke Ricks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700613387 PECOS PAC ID: 0143755132 Enrollment ID: I20241127003090 |
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