Active NPI
Lean on Me Therapy
- Community/Behavioral Health Agency
- Clinton, IA
National Provider Identifier
1003092214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 06264
- Legal business name
- LEAN ON ME THERAPY
- Practice address
- 500 Oakhurst Dr., Apt. 6
Clinton, IA 52732-3619 - Phone
- (563) 581-2673
- NPI assigned
- Jan 17, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miranda S Bohlken, LISW
- Title
- Owner
- Phone
- (563) 581-2673
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 06264 | IA | Primary |
Addresses
Primary practice location
500 Oakhurst Dr., Apt. 6
Clinton, IA 52732-3619
Mailing address
500 Oakhurst Dr., Apt. 6
Clinton, IA 52732-3619
Phone (563) 581-2673
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0201259 | Medicaid | IA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1244764800000",
"number": "1003092214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 OAKHURST DR., APT. 6",
"city": "CLINTON",
"state": "IA",
"postal_code": "527323619",
"telephone_number": "563-581-2673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 OAKHURST DR., APT. 6",
"city": "CLINTON",
"state": "IA",
"postal_code": "527323619",
"telephone_number": "563-581-2673"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEAN ON ME THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-17",
"last_updated": "2009-06-12",
"status": "A",
"authorized_official_last_name": "BOHLKEN",
"authorized_official_first_name": "MIRANDA",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "563-581-2673",
"authorized_official_credential": "LISW"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "IA",
"license": "06264",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0201259",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.