Individual provider Active NPI

Robert Scott Andrews, MS LMHC NCC

  • Mental Health Counselor
  • Council Bluffs, IA
National Provider Identifier
1053568345
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001147 Issued in IA
Practice address
300 W Broadway Ste 107
Council Bluffs, IA 51503-4489
Phone
(712) 328-3700
NPI assigned
Aug 19, 2008
Last updated
Aug 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001147 IA Primary

Addresses

Primary practice location

300 W Broadway Ste 107
Council Bluffs, IA 51503-4489

Mailing address

300 W Broadway Ste 107
Council Bluffs, IA 51503-4489
Phone (712) 328-3700

Other identifiers 2

IdentifierTypeStateIssuer
0487348MedicaidIA
1013490MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125003208 IA Practitioner - Mental Health Counselor 2668824848 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Mind Therapy LLC Mental Health CurrentSince Jan 4, 2024 Accepting new patients

Locations

35 Main Pl
Ste 100
Council Bluffs, IA 51503
Phone (712) 256-9902

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1053568345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY STE 107",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034489",
            "telephone_number": "712-328-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY STE 107",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034489",
            "telephone_number": "712-328-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "MS   LMHC  NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487348",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013490",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.