Marisa Catherine Mickunas, MS CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

090226 Issued in IA

Practice address

1301 Center St
Des Moines, IA 50309-1004

Phone

(515) 243-2760

Fax

(515) 243-2760

NPI assigned

Apr 16, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1053808006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 31ST ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503112810",
            "telephone_number": "515-402-3799",
            "fax_number": "515-243-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CENTER ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091004",
            "telephone_number": "515-243-2760",
            "fax_number": "515-243-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKUNAS",
        "first_name": "MARISA",
        "middle_name": "CATHERINE",
        "credential": "MS CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "090226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Ray Meylor, D.C.
• Michael S Lee DPM PC
• Bozena Michalska, MA
• Mollie S Michelfelder, LISW, CADC
• John M Micka Jr., MD
• Mid-Iowa Home Care Corporation
• Sara Middendorf
• Midwest Ambucare
• Midwest Ambulance Service of Iowa Inc
• Midwest Medical Transport Company LLC

• Mental Health Counselor in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.