Northeast Iowa Behavioral Health, Inc. | |
905 Montgomery St Decorah IA 52101-2325 | |
(563) 382-3649 | |
(563) 382-8183 |
Full Name | Northeast Iowa Behavioral Health, Inc. |
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Speciality | Clinic/Center |
Location | 905 Montgomery St, Decorah, Iowa |
Authorized Official Name and Position | Marcia Oltrogge (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5633823649 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northeast Iowa Behavioral Health, Inc. Po Box 349 905 Montgomery St. Decorah IA 52101-0349 Ph: (563) 382-3649 | Northeast Iowa Behavioral Health, Inc. 905 Montgomery St Decorah IA 52101-2325 Ph: (563) 382-3649 |
NPI Number | 1710933445 |
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Provider Enumeration Date | 05/25/2006 |
Last Update Date | 04/18/2012 |
Medicare PECOS PAC ID | 1355230475 |
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Medicare Enrollment ID | O20040315000839 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710933445 | NPI | - | NPPES |
0074559 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | NONE (Iowa) | Primary |
Provider Name | William Bernard Deutsch |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1609179787 PECOS PAC ID: 8426210758 Enrollment ID: I20120503000324 |
Provider Name | Christel J Rinehart |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952689523 PECOS PAC ID: 6507037504 Enrollment ID: I20130122000568 |
Provider Name | Kovilparambil Antony |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1376677138 PECOS PAC ID: 7113910266 Enrollment ID: I20140630001733 |
Provider Name | Laura J Zielinski |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1801148366 PECOS PAC ID: 8729212477 Enrollment ID: I20210628000965 |
Provider Name | Kathryn Johnson |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1356787873 PECOS PAC ID: 7012142953 Enrollment ID: I20210907000129 |
Provider Name | Erin Anderson |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164980462 PECOS PAC ID: 0345634101 Enrollment ID: I20220222001396 |
Provider Name | Margaret A Throckmorton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902372790 PECOS PAC ID: 3072859511 Enrollment ID: I20220707003928 |
Provider Name | Elizabeth Anne Mcerlean |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1942760137 PECOS PAC ID: 0042636557 Enrollment ID: I20230201000466 |
Provider Name | Megan Andera |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1083225130 PECOS PAC ID: 1759746258 Enrollment ID: I20230506000224 |
Provider Name | Matthew Homstad |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1134574064 PECOS PAC ID: 1658729710 Enrollment ID: I20231129003280 |
Provider Name | Nicole Brevig |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1659938165 PECOS PAC ID: 8022466069 Enrollment ID: I20231130003031 |
Provider Name | Kendrah Parker |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1427456581 PECOS PAC ID: 1254780562 Enrollment ID: I20231212003352 |
Provider Name | Adam Elwood |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1376109132 PECOS PAC ID: 2769832633 Enrollment ID: I20231219002694 |
Provider Name | Anita Green |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1255118485 PECOS PAC ID: 7113364480 Enrollment ID: I20240321003369 |
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