| Southwest Iowa Mental Health Center | |
|
2307 Olive St Atlantic IA 50022-9768 | |
| (712) 243-2606 | |
| (712) 243-2688 |
| Full Name | Southwest Iowa Mental Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 2307 Olive St, Atlantic, Iowa |
| Authorized Official Name and Position | Laurie Cooley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7122432606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Iowa Mental Health Center Po Box 34 Atlantic IA 50022-0034 Ph: (712) 243-2606 | Southwest Iowa Mental Health Center 2307 Olive St Atlantic IA 50022-9768 Ph: (712) 243-2606 |
| NPI Number | 1033181086 |
|---|---|
| Provider Enumeration Date | 02/03/2006 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Medicare PECOS PAC ID | 9234027129 |
|---|---|
| Medicare Enrollment ID | O20040310001151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033181086 | NPI | - | NPPES |
| D0893 | Other | IA | BCBS OF IA |
| 0008938 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brenda L Hoskins-mein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336121755 PECOS PAC ID: 3072594951 Enrollment ID: I20040526001227 |
| Provider Name | Dianna Prokupek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194797449 PECOS PAC ID: 8628013588 Enrollment ID: I20050622000538 |
| Provider Name | Ivan R Delgado Ramos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982675559 PECOS PAC ID: 9739203340 Enrollment ID: I20100903000462 |
| Provider Name | Sharon L Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619917317 PECOS PAC ID: 7517152911 Enrollment ID: I20101111000246 |
| Provider Name | Stephanie E Heitman-taggart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417212358 PECOS PAC ID: 1456667765 Enrollment ID: I20150901003022 |
| Provider Name | Cynthia R Jeffrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063054765 PECOS PAC ID: 3476984568 Enrollment ID: I20200505000895 |
| Provider Name | Megan F Caballero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972117679 PECOS PAC ID: 7214354356 Enrollment ID: I20200903000950 |
| Provider Name | Tarrah L Holliday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114521721 PECOS PAC ID: 3173936309 Enrollment ID: I20210108000207 |
| Provider Name | Billie Rael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134712821 PECOS PAC ID: 4981010790 Enrollment ID: I20210302002741 |
| Provider Name | Jennifer A Gravenish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164093399 PECOS PAC ID: 6406246198 Enrollment ID: I20211213001495 |
| Provider Name | Michelle Lindsey Vore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427709278 PECOS PAC ID: 9830576842 Enrollment ID: I20220512002296 |
| Provider Name | Andrea L Blunck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245904341 PECOS PAC ID: 5294118485 Enrollment ID: I20220822001157 |
| Provider Name | Shelli Dee Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255058640 PECOS PAC ID: 8921476771 Enrollment ID: I20221129000302 |
Nishna Valley Mental Health, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 E 5th St, Atlantic, IA 50022 Phone: 712-249-7054 | |
Zion Integrated Behavioral Health Services Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2307 Olive St Apt 1, Atlantic, IA 50022 Phone: 712-243-2606 Fax: 712-243-1337 | |
Therapy Place, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 101 E 22nd St, Atlantic, IA 50022 Phone: 712-254-9018 Fax: 712-254-9019 | |
Hope Recovery Center Llc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Linn St, Atlantic, IA 50022 Phone: 712-243-1700 | |
Sue's Kids Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1806 Sycamore Ave, Atlantic, IA 50022 Phone: 712-254-0108 | |
Zion Integrated Behavioral Health Services Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2307 Olive St, Atlantic, IA 50022 Phone: 712-243-5091 Fax: 712-243-1337 |