| Southwest Iowa Families Inc | |
|
215 E Washington St Clarinda IA 51632-1625 | |
| (712) 542-3501 | |
| (712) 542-4725 |
| Full Name | Southwest Iowa Families Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 215 E Washington St, Clarinda, Iowa |
| Authorized Official Name and Position | Berneeta L Wagoner (AGENCY DIRECTOR) |
| Authorized Official Contact | 7125423501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Iowa Families Inc 215 E Washington St Clarinda IA 51632-1625 Ph: (712) 542-3501 | Southwest Iowa Families Inc 215 E Washington St Clarinda IA 51632-1625 Ph: (712) 542-3501 |
| NPI Number | 1689762882 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 12/18/2007 |
| Medicare PECOS PAC ID | 7315840428 |
|---|---|
| Medicare Enrollment ID | O20040128000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689762882 | NPI | - | NPPES |
| 10025357200 | Other | NE | NE MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Berneeta L Wagoner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699863894 PECOS PAC ID: 8820990096 Enrollment ID: I20040127000435 |
| Provider Name | Angela R Wallick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912230756 PECOS PAC ID: 9335399468 Enrollment ID: I20121025000211 |
| Provider Name | Lydia K Rothfusz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003341140 PECOS PAC ID: 2264867621 Enrollment ID: I20200114001459 |
| Provider Name | Amber Butt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407060130 PECOS PAC ID: 3678918562 Enrollment ID: I20240301001120 |
| Provider Name | Robbie Hickman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790873982 PECOS PAC ID: 8729981840 Enrollment ID: I20240410003964 |
Waubonsie Mental Health Center Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 216 W Division St, Clarinda, IA 51632 Phone: 712-542-2388 Fax: 712-542-2984 | |
Harbor Point Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 218 W Division St, Clarinda, IA 51632 Phone: 712-850-1389 Fax: 712-215-7184 |