Active NPI
Family Advocacy Resources
- Mental Health Counselor
- Woodward, IA
National Provider Identifier
1215084454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 00417
- Legal business name
- FAMILY ADVOCACY RESOURCES
- Practice address
- 124 South Main
Woodward, IA 50276 - Phone
- (515) 438-4214
- Fax
- (515) 438-4217
- NPI assigned
- Jan 3, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Charles Wilkinson
- Title
- Administrator
- Phone
- (515) 438-4214
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 02516 | IA | |
| Mental Health Counselor | 101YM0800X | 00417 | IA | Primary |
Addresses
Primary practice location
124 South Main
Woodward, IA 50276
Mailing address
PO Box 410
Woodward, IA 50276-0410
Phone (515) 438-4214
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0266627 | Medicaid | IA | |
| 0266981 | Medicaid | IA |
National Provider Directory
National Provider Directory- Tax ID family
- Family Advocacy Resources
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Woodward, IA
- NPI 1104819473
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Clinical Social Worker
- Emmetsburg, IA
- NPI 1356561781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1215084454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 410",
"city": "WOODWARD",
"state": "IA",
"postal_code": "502760410",
"telephone_number": "515-438-4214",
"fax_number": "515-438-4217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 SOUTH MAIN",
"city": "WOODWARD",
"state": "IA",
"postal_code": "50276",
"telephone_number": "515-438-4214",
"fax_number": "515-438-4217"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY ADVOCACY RESOURCES",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WILKINSON",
"authorized_official_first_name": "CHARLES",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "515-438-4214",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "02516",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "00417",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0266627",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0266981",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Woodward, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.