Organization Active NPI

Lean on Me Therapy

  • Community/Behavioral Health Agency
  • Clinton, IA
National Provider Identifier
1003092214
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
06264 Issued in IA
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

Updated by the provider on Jun 12, 2009

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0201259MedicaidIA

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.