NPIMap

Organization Active NPI

Family Counseling & Psychology Center P.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bettendorf, IA
National Provider Identifier
1083719587
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FAMILY COUNSELING & PSYCHOLOGY CENTER P.C.
Practice address
2485 Tech Dr
Bettendorf, IA 52722-3262
Phone
(563) 355-1611
Fax
(563) 355-6617
NPI assigned
Sep 13, 2006
Last updated
Jun 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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

Authorized official

Name
Collin Andrew Lodico, PH. D.NPI 1528161429
Title
Owner
Phone
(563) 355-1611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2485 Tech Dr
Bettendorf, IA 52722-3262

Mailing address

2485 Tech Dr
Bettendorf, IA 52722-3262
Phone (563) 355-1611

Other identifiers 1

IdentifierTypeStateIssuer
0263178MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000643 IA Part B Supplier - Clinic/Group Practice 0648249177 Receives reassigned benefits from 1 practitioner
Practice locations: Bettendorf, IA

National Provider Directory

National Provider Directory
Tax ID family
Collin a Lodico2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2380 Cumberland Square Dr
Bettendorf, IA 52722
Phone (319) 359-3551

2485 Tech Dr
Bettendorf, IA 52722
Phone (563) 355-1611

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1083719587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 TECH DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223262",
            "telephone_number": "563-355-1611",
            "fax_number": "563-355-6617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 TECH DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223262",
            "telephone_number": "563-355-1611",
            "fax_number": "563-355-6617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY COUNSELING & PSYCHOLOGY CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "LODICO",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-355-1611",
        "authorized_official_credential": "PH. D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263178",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.