NPIMap

Organization Active NPI

Catholic Charities

  • Mental Health Counselor
  • Fort Dodge, IA
National Provider Identifier
1174877641
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
007700 Issued in IA
Legal business name
CATHOLIC CHARITIES
Practice address
1200 3Rd Ave NW
Suite 1
Fort Dodge, IA 50501-2207
Phone
(515) 576-4156
Fax
(515) 576-6998
NPI assigned
Nov 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Authorized official

Name
Mr. Jerry Eaton, LMSW
Title
Excutive Director
Phone
(712) 252-4547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 007700 IA Primary

Addresses

Primary practice location

1200 3Rd Ave NW
Suite 1
Fort Dodge, IA 50501-2207

Mailing address

1200 3Rd Ave NW
Suite 1
Fort Dodge, IA 50501-2207
Phone (515) 576-4156

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities2 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

1200 3rd Ave NW
Ste 1
Fort Dodge, IA 50501
Phone (515) 576-4156

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1174877641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 3RD AVE NW",
            "address_2": "SUITE 1",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505012207",
            "telephone_number": "515-576-4156",
            "fax_number": "515-576-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 3RD AVE NW",
            "address_2": "SUITE 1",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505012207",
            "telephone_number": "515-576-4156",
            "fax_number": "515-576-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "EXCUTIVE DIRECTOR",
        "authorized_official_telephone_number": "712-252-4547",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "007700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.