Organization Active NPI

Kristi Clements Counseling LLC

  • Clinical Social Worker
  • Waterloo, IA
National Provider Identifier
1013702836
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KRISTI CLEMENTS COUNSELING LLC
Practice address
3606 Kimball Ave Ste 16
Waterloo, IA 50702-5731
Phone
(319) 250-2729
NPI assigned
Apr 11, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Kristi Clements, LISWNPI 1629251574
Title
Therapist/Owner
Phone
(319) 939-1968

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

3606 Kimball Ave Ste 16
Waterloo, IA 50702-5731

Mailing address

3606 Kimball Ave Ste 16
Waterloo, IA 50702-5731
Phone (319) 250-2729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250516002422 IA Part B Supplier - Clinic/Group Practice 6305364951 Receives reassigned benefits from 1 practitioner
Practice locations: Waterloo, IA

National Provider Directory

National Provider Directory

Locations

3606 Kimball Ave
Ste 16
Waterloo, IA 50702
Phone (319) 250-2729

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": "1744329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1013702836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 KIMBALL AVE STE 16",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025731",
            "telephone_number": "319-250-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 KIMBALL AVE STE 16",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025731",
            "telephone_number": "319-250-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTI CLEMENTS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "319-939-1968",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "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 Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.