Individual provider Active NPI

Ryan Joel Emerson, LMHC

  • Mental Health Counselor
  • Grinnell, IA
National Provider Identifier
1104064153
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
074580 Issued in IA
Practice address
807 4TH Ave
Grinnell, IA 50112-2042
Phone
(641) 510-1381
Fax
(641) 243-2149
NPI assigned
Jan 29, 2009
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

807 4TH Ave
Grinnell, IA 50112-2042
Phone (641) 510-1381

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240226000709 IA Practitioner - Mental Health Counselor 8426493826 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
074580IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling LLC CurrentSince Jul 1, 2024 Accepting new patients
Poweshiek County Mental Health Center PastSince Feb 1, 2022 Accepting new patients

Locations

807 4th Ave
Grinnell, IA 50112
Phone (641) 510-1381

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 074580 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

807 4TH Ave
Grinnell, IA 50112-2042

Mailing address

807 4TH Ave
Grinnell, IA 50112-2042
Phone (641) 569-8953

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
4226765MedicaidIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 2, 2026.

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1104064153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122042",
            "telephone_number": "641-569-8953",
            "fax_number": "641-243-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501122042",
            "telephone_number": "641-510-1381",
            "fax_number": "641-243-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERSON",
        "first_name": "RYAN",
        "middle_name": "JOEL",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-29",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "074580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4226765",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

Verify at the official NPI Registry.