Youth Shelter Care of North Central Iowa Inc

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC

Practice address

301 Avenue M W
Fort Dodge, IA 50501-5623

Phone

(515) 955-4834

Fax

(515) 955-6828

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Laurence R McLuckie, LMSW, MBA

Title

Executive Director

Phone

(515) 955-4834

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003979139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 AVENUE M W",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015623",
            "telephone_number": "515-955-4834",
            "fax_number": "515-955-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 AVENUE M W",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015623",
            "telephone_number": "515-955-4834",
            "fax_number": "515-955-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCLUCKIE",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "515-955-4834",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW, MBA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0466243",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1153908",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Lerae Woodley
• Emily Ann Wubben, ARNP
• Richard B Wyatt, MD
• Rhonda R Wykoff, LMHC
• Suzanne K Yoder, HIS
• Rosalyn M Zach, ARNP
• Angie Zdrazil
• Jennifer Saari Zigrang, ARNP

• Counselor in Fort Dodge, IA
• Providers in Fort Dodge, IA by specialty
• Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.