|
| |
|
1290 Jordan St North Liberty IA 52317-8020 | |
| (319) 356-6352 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1290 Jordan St, North Liberty, Iowa |
| Authorized Official Name and Position | Ann Eiden (VP OF CORPORATE SERVICES) |
| Authorized Official Contact | 6513791750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1900 Silver Lake Rd Nw New Brighton MN 55112-1786 Ph: (651) 628-9566 | 1290 Jordan St North Liberty IA 52317-8020 Ph: (319) 356-6352 |
| NPI Number | 1568121457 |
|---|---|
| Provider Enumeration Date | 12/08/2021 |
| Last Update Date | 10/24/2023 |
| Certification Date | 10/24/2023 |
| Medicare PECOS PAC ID | 9638550544 |
|---|---|
| Medicare Enrollment ID | O20220722001283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568121457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Sheila R Aukes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639263536 PECOS PAC ID: 9133172521 Enrollment ID: I20050225000183 |
| Provider Name | Dennis L Dozier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245411339 PECOS PAC ID: 1850455916 Enrollment ID: I20090204000347 |
| Provider Name | Bridget M Baechtel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578716452 PECOS PAC ID: 8426207093 Enrollment ID: I20120926000266 |
| Provider Name | Joshua W Curphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740662394 PECOS PAC ID: 3476868928 Enrollment ID: I20150813009957 |
| Provider Name | Kathleen F Rousseau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053783175 PECOS PAC ID: 7911207162 Enrollment ID: I20151120000084 |
| Provider Name | Lacey R Cheeseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851831499 PECOS PAC ID: 6608151196 Enrollment ID: I20170324000447 |
| Provider Name | Michael R Inman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184025819 PECOS PAC ID: 3274803218 Enrollment ID: I20170724002393 |
| Provider Name | Kellie Kristine Bement |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487170718 PECOS PAC ID: 9638445059 Enrollment ID: I20171030001067 |
| Provider Name | Margaret M Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508219031 PECOS PAC ID: 8224397898 Enrollment ID: I20180108000460 |
| Provider Name | Christina L Aquino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215307111 PECOS PAC ID: 0648530048 Enrollment ID: I20180202001629 |
| Provider Name | Tara J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497263008 PECOS PAC ID: 4789944547 Enrollment ID: I20180216000862 |
| Provider Name | John J. Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508044454 PECOS PAC ID: 5395093942 Enrollment ID: I20180730003177 |
| Provider Name | Curtis L Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588181481 PECOS PAC ID: 5193074995 Enrollment ID: I20180827002787 |
| Provider Name | Ryan Mcclure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255500385 PECOS PAC ID: 5092069989 Enrollment ID: I20181112002657 |
| Provider Name | Barbara Anne Geren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750830097 PECOS PAC ID: 6800176934 Enrollment ID: I20190927001498 |
| Provider Name | Katherine J Shea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619598869 PECOS PAC ID: 6901237536 Enrollment ID: I20200514000491 |
| Provider Name | Jaime Mcclure |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487880001 PECOS PAC ID: 5395033476 Enrollment ID: I20210708000238 |
| Provider Name | Matthew Walter Kressin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982966412 PECOS PAC ID: 3779988837 Enrollment ID: I20210827000869 |
| Provider Name | David Primeau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417307950 PECOS PAC ID: 2860882867 Enrollment ID: I20211207000176 |
| Provider Name | Natasha M Lash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356096572 PECOS PAC ID: 4789078437 Enrollment ID: I20220223002246 |
| Provider Name | Jonathan C Uecker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659334092 PECOS PAC ID: 5193786614 Enrollment ID: I20220722001365 |
| Provider Name | Nathan Porter Schulz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922419811 PECOS PAC ID: 4385944321 Enrollment ID: I20230127001939 |
| Provider Name | Kathryn E Foltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730898198 PECOS PAC ID: 3678947512 Enrollment ID: I20230316001093 |
| Provider Name | Blake Jeffrey Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396393021 PECOS PAC ID: 9537534284 Enrollment ID: I20230411000654 |
| Provider Name | Kelly A Mayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962990267 PECOS PAC ID: 6103281241 Enrollment ID: I20230425002280 |
| Provider Name | Brittany Ann Brdicko |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770197436 PECOS PAC ID: 2860877628 Enrollment ID: I20230502001070 |
| Provider Name | Michael E Mcinroy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831657857 PECOS PAC ID: 6204291990 Enrollment ID: I20230502002943 |
| Provider Name | Amy Beth Lapham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750499976 PECOS PAC ID: 3577924968 Enrollment ID: I20230801004302 |
| Provider Name | Emily Marie Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609532472 PECOS PAC ID: 6406201268 Enrollment ID: I20231013001861 |
| Provider Name | Abbie Leann Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114510575 PECOS PAC ID: 3274989033 Enrollment ID: I20231031000246 |
| Provider Name | Hannah Rose Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215509062 PECOS PAC ID: 4486001823 Enrollment ID: I20231107002680 |
| Provider Name | Samantha Kemp Carlin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871957803 PECOS PAC ID: 2062860786 Enrollment ID: I20231118000211 |
| Provider Name | Laurene Franco |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386317238 PECOS PAC ID: 6002264587 Enrollment ID: I20231121003401 |
| Provider Name | Annie Lee Kramer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063065571 PECOS PAC ID: 7214385731 Enrollment ID: I20231122000505 |
| Provider Name | Courtney Hale Cook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659684363 PECOS PAC ID: 1759739279 Enrollment ID: I20231122000555 |
| Provider Name | Kaylie Morsch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811368277 PECOS PAC ID: 9931557493 Enrollment ID: I20231122002155 |
| Provider Name | Traci Jo Biddle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992339287 PECOS PAC ID: 9830547298 Enrollment ID: I20231122002545 |
| Provider Name | Jenna Marie Swallow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972153955 PECOS PAC ID: 5496103863 Enrollment ID: I20231122002917 |
| Provider Name | Tiffany Deeann Cloke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174957427 PECOS PAC ID: 9739537101 Enrollment ID: I20231122002992 |
| Provider Name | Felicia Luz Pope |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487167680 PECOS PAC ID: 2163870502 Enrollment ID: I20231127001236 |
| Provider Name | Angela Marie Hunt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689189599 PECOS PAC ID: 4082062336 Enrollment ID: I20231127001666 |
| Provider Name | Molly Khang |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063286938 PECOS PAC ID: 3173971405 Enrollment ID: I20231128001592 |
| Provider Name | Kathleen Lynn Gillespie-jensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144735465 PECOS PAC ID: 5799133799 Enrollment ID: I20231201001144 |
| Provider Name | Dustin D Ernberger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487684643 PECOS PAC ID: 4688023153 Enrollment ID: I20231208001728 |
| Provider Name | Catherine Norwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043682248 PECOS PAC ID: 1951750090 Enrollment ID: I20231214000523 |
| Provider Name | Jessica Ann Brown-coffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215701040 PECOS PAC ID: 2365891256 Enrollment ID: I20231218003806 |
| Provider Name | Greg Fuqua |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295351179 PECOS PAC ID: 5890145411 Enrollment ID: I20231222001364 |
| Provider Name | Christopher Alan Marks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366992521 PECOS PAC ID: 0941553937 Enrollment ID: I20231222001402 |
| Provider Name | Crystal A Boyles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922605948 PECOS PAC ID: 6103276738 Enrollment ID: I20231222001608 |
| Provider Name | Stephanie Ruth Warwas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972015899 PECOS PAC ID: 6406284421 Enrollment ID: I20240113000618 |
| Provider Name | Molly Anne St Clair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306611421 PECOS PAC ID: 9931552403 Enrollment ID: I20240131003396 |
| Provider Name | Shidonna Nicole Steen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134895014 PECOS PAC ID: 4587007810 Enrollment ID: I20240203000140 |
| Provider Name | Kristine Marie Long |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245975937 PECOS PAC ID: 2860838943 Enrollment ID: I20240312000689 |
| Provider Name | Allie Nicole Rieken |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477165025 PECOS PAC ID: 6002256807 Enrollment ID: I20240426001534 |
| Provider Name | Jacqueline Blair Schimel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104583186 PECOS PAC ID: 0042652299 Enrollment ID: I20240520003715 |
| Provider Name | Kalee R Culver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124868419 PECOS PAC ID: 9739621509 Enrollment ID: I20240607001574 |
| Provider Name | Isaura Del Carmen Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851886360 PECOS PAC ID: 0840734240 Enrollment ID: I20240626003041 |
| Provider Name | Abbey Leigh Olderog |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982276911 PECOS PAC ID: 0345785796 Enrollment ID: I20240710003472 |
| Provider Name | Logan Malone Murphy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689344863 PECOS PAC ID: 7315470713 Enrollment ID: I20241023003883 |
| Provider Name | Timothy Fairbanks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619693785 PECOS PAC ID: 3274066618 Enrollment ID: I20241024000523 |
Journey Counseling Services Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 555 W Cherry St Ste 3, North Liberty, IA 52317 Phone: 319-541-7253 | |
Holistic Wellness & Psychiatry Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 W Cherry St, North Liberty, IA 52317 Phone: 319-800-2125 Fax: 855-300-4759 | |
Rise Family Therapy Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 595 Ashley Ct Ste 1, North Liberty, IA 52317 Phone: 319-626-2244 Fax: 319-409-9265 | |
Family Wellbeing Associates, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 723 Pacha Pkwy, North Liberty, IA 52317 Phone: 319-775-0074 Fax: 319-774-6775 | |
Imagine Therapy Solutions, Plc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 575 Cameron Way, Unit A, North Liberty, IA 52317 Phone: 319-626-2558 | |
Wise Home Care Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 N Park Ridge Rd, North Liberty, IA 52317 Phone: 319-400-8579 |