CCST, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

06044 Issued in IA

Legal business name

CCST, LLC

Practice address

2521 Elwood Dr
Suite 121
Ames, IA 50010-8229

Phone

(515) 291-1499

Fax

(515) 292-2184

NPI assigned

Jun 25, 2006

Organization subpart

No

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

Authorized official

Name

Cathy Sue Nelson, LISW

Title

Owner of Business

Phone

(515) 291-1499

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043246440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 ELWOOD DR",
            "address_2": "SUITE 121",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500108229",
            "telephone_number": "515-291-1499",
            "fax_number": "515-292-2184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 ELWOOD DR",
            "address_2": "SUITE 121",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500108229",
            "telephone_number": "515-291-1499",
            "fax_number": "515-292-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER OF BUSINESS",
        "authorized_official_telephone_number": "515-291-1499",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145 9909",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA MCAID ENT W DSM IA",
            "identifier": "045 9909",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B CROSS B SHIELD WELLMARK",
            "identifier": "36996",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "244574",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Madison Renae Chafa
• Chaz Chambers, DDS

• Clinical Social Worker in Ames, IA
• Providers in Ames, IA by specialty
• Clinical Social Worker 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.