Active NPI
Marion Bettina Niles, TLMHC
- Mental Health Counselor
- Burlington, IA
National Provider Identifier
1063661387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 083763
- Practice address
- 400 S Broadway St
Burlington
Burlington, IA 52601-9407 - Phone
- (319) 752-4000
- Fax
- (319) 752-6933
- NPI assigned
- Sep 10, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 083763 | IA | Primary |
Addresses
Primary practice location
400 S Broadway St
Burlington
Burlington, IA 52601-9407
Mailing address
400 S Broadway St
Burlington
Burlington, IA 52601-9407
Phone (319) 752-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 29, 2024 through Jan 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 083763 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1063661387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S BROADWAY ST",
"address_2": "BURLINGTON",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "526019407",
"telephone_number": "319-752-4000",
"fax_number": "319-752-6933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 S BROADWAY ST",
"address_2": "BURLINGTON",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "526019407",
"telephone_number": "319-752-4000",
"fax_number": "319-752-6933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILES",
"first_name": "MARION",
"middle_name": "BETTINA",
"name_prefix": "Ms.",
"credential": "TLMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-10",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "083763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.