Individual provider Active NPI

Elissa Ann O'Dell, TLMHC

  • Mental Health Counselor
  • Rock Valley, IA
National Provider Identifier
1104715077
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
133025 Issued in IA
Practice address
1905 10TH St
Rock Valley, IA 51247-1630
Phone
(712) 476-5245
NPI assigned
Jul 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 133025 IA Primary

Addresses

Primary practice location

1905 10TH St
Rock Valley, IA 51247-1630

Mailing address

417 1St St NE
Orange City, IA 51041-2142
Phone (712) 438-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
133025IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Living Center, P.C. CurrentSince Jul 9, 2025 Accepting new patients

Locations

1905 10th St
Rock Valley, IA 51247
Phone (712) 476-5245

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1104715077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 1ST ST NE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510412142",
            "telephone_number": "712-438-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 10TH ST",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471630",
            "telephone_number": "712-476-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "ELISSA",
        "middle_name": "ANN",
        "credential": "TLMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "133025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Valley, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.