Faith and Freedom Therapy LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

FAITH AND FREEDOM THERAPY LLC

Practice address

974 73Rd St Ste 24
West Des Moines, IA 50265-1200

Phone

(515) 344-3144

NPI assigned

Dec 6, 2024

Last updated

Dec 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Fasse, LISWNPI 1043796295

Title

Owner

Phone

(515) 344-3144

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathan S Fasse

  • Social Worker
  • Des Moines, IA
  • NPI 1043796295
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1083420798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "974 73RD ST STE 24",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502651200",
            "telephone_number": "515-344-3144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "974 73RD ST STE 24",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502651200",
            "telephone_number": "515-344-3144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH AND FREEDOM THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "FASSE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-344-3144",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.