The Me I Want to Be, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

THE ME I WANT TO BE, LLC

Practice address

3 Goethe St
Guttenberg, IA 52052-9319

Phone

(563) 362-2379

Fax

(563) 334-7970

NPI assigned

Apr 24, 2020

Organization subpart

No

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

Authorized official

Name

Diane Baumgartner

Title

Owner

Phone

(563) 362-2379

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587686400000",
    "number": "1033739503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "520520285",
            "telephone_number": "563-362-2379",
            "fax_number": "563-334-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 GOETHE ST",
            "city": "GUTTENBERG",
            "state": "IA",
            "postal_code": "520529319",
            "telephone_number": "563-362-2379",
            "fax_number": "563-334-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ME I WANT TO BE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-24",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A",
        "authorized_official_last_name": "BAUMGARTNER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-362-2379"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.