Organization Active NPI

New Leaf Mental Health Therapy LLC.

  • Clinical Social Worker
  • Clive, IA
National Provider Identifier
1205492089
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
NEW LEAF MENTAL HEALTH THERAPY LLC.
Practice address
12951 University Ave Ste 200C
Clive, IA 50325-8297
Phone
(515) 832-0528
NPI assigned
May 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Laura Ann Nydam, LISWNPI 1851732481
Title
Owner
Phone
(515) 832-0528

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

12951 University Ave Ste 200C
Clive, IA 50325-8297

Mailing address

2755 NW 165TH St
Clive, IA 50325-2514
Phone (515) 238-0528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190909002929 IA Part B Supplier - Clinic/Group Practice 2466781968 Receives reassigned benefits from 1 practitioner
Practice locations: Clive, IA

National Provider Directory

National Provider Directory

Locations

12951 University Ave
Ste 200C
Clive, IA 50325
Phone (515) 832-0528

Practitioners & affiliated clinicians

Practitioners 1

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": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1205492089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 NW 165TH ST",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503252514",
            "telephone_number": "515-238-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12951 UNIVERSITY AVE STE 200C",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503258297",
            "telephone_number": "515-832-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEAF MENTAL HEALTH THERAPY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "NYDAM",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-832-0528",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.