John R. Church, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001065 Issued in IA

Practice address

847 W 4TH St
Waterloo, IA 50702-2141

Phone

(319) 215-8197

NPI assigned

Sep 7, 2009

Sex

Male

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)

Enrolled

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

{
    "created_epoch": "1252281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1093048282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 MATTHEW DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013563",
            "telephone_number": "319-215-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 W 4TH ST",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507022141",
            "telephone_number": "319-215-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "JOHN",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-07",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Paul Christensen, DDS MS
• Rachel Christensen
• Christensen,Christensen & Freeseman,PC
• Tina Christian, HIS
• Hosung Chung, M.D.
• City Builders and Supplies
• City of Waterloo
• Clark and Associates, Inc
• Jessica Nicole Clark, NP-C
• Kirby P Clark, M.D.

• Mental Health Counselor in Waterloo, IA
• Providers in Waterloo, 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 Sep 19, 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.