Mandi Dolieslager, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086471 Issued in IA

Practice address

400 Central Ave NW Ste 300
Orange City, IA 51041-1332

Phone

(712) 737-2635

Fax

(712) 737-2344

NPI assigned

Jun 26, 2017

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

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bethesda Christian Counseling Midwest IncGroup PAC ID 6608869078, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• IA HMO

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.

• Bethesda Christian Counseling Midwest, Inc.

  dba Bethesda Christian Counseling

  • Psychiatry Physician
  • Sioux Falls, SD
  • NPI 1376522060

  Clinical, IA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053831586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE NW STE 300",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411332",
            "telephone_number": "712-737-2635",
            "fax_number": "712-737-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CENTRAL AVE NW STE 300",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411332",
            "telephone_number": "712-737-2635",
            "fax_number": "712-737-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLIESLAGER",
        "first_name": "MANDI",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "086471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW LICENSE NUMBER",
            "identifier": "086471",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• De Jong Chiropractic
• Mihret De Jong
• Daron Kenneth Dejong, DC
• Teresa Dekkers, MSW
• George Devries, CRNA
• Deejay Donlin, PHD
• Taylor William Dreise, DO
• Kirsten Joy Dunia
• Ana Dunlavey, OTD, OTR/L
• Dutch Mill Corporation (Dutch Mill Pharmacy)

• Clinical Social Worker in Orange City, IA
• Providers in Orange City, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.