Annalee Rose Moody

Key facts

NPI

1104431386

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

097640 (IA)

Practice address

523 1/2 Court Street
Williamsburg, IA 52361-5236

Phone

(319) 668-1217

Fax

(319) 668-1220

NPI assigned

Sep 14, 2020

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 14, 2020.

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1104431386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 10TH AVENUE PL",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522411778",
            "telephone_number": "309-737-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 1/2 COURT STREET",
            "city": "WILLIAMSBURG",
            "state": "IA",
            "postal_code": "523615236",
            "telephone_number": "319-668-1217",
            "fax_number": "319-668-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "ANNALEE",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "097640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, IA

• Brian Marovets, M.D.
• Cami Marshall
• MCLD Corporation
• MCLD Corporation
• Midwest Counseling, LLC
• Jacob Riley Mauricio Nelson, D.C
• Gregory P Neyman, M.D.
• Theodora Naa Adukai Okine
• Olivia Parmelee, DC
• Resolve Medical PLLC

All providers in Williamsburg, IA · Mental Health Counselor in Iowa