Organization Active NPI

Deep Well LLC

  • Clinical Social Worker
  • Ames, IA
National Provider Identifier
1003737263
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
DEEP WELL LLC
Practice address
3103 Maplewood Rd
Ames, IA 50014-4572
Phone
(641) 919-0765
NPI assigned
Jul 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sidney Barker, LISW
Title
Memer
Phone
(641) 919-0765

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3103 Maplewood Rd
Ames, IA 50014-4572

Mailing address

3103 Maplewood Rd
Ames, IA 50014-4572
Phone (641) 919-0765

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1003737263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 MAPLEWOOD RD",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500144572",
            "telephone_number": "641-919-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 MAPLEWOOD RD",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500144572",
            "telephone_number": "641-919-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP WELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "MEMER",
        "authorized_official_telephone_number": "641-919-0765",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.