NPIMap

Organization Active NPI

North Iowa Counseling, LLC

  • Clinical Social Worker
  • Waverly, IA
National Provider Identifier
1225514540
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
NORTH IOWA COUNSELING, LLC
Practice address
506 E Bremer Ave
Waverly, IA 50677
Phone
(319) 559-1065
Fax
(319) 575-6065
NPI assigned
Jul 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Mr. Brad D Hjelmeland, LISW IADC
Title
Executive Director/Clinician
Phone
(319) 559-1065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

506 E Bremer Ave
Waverly, IA 50677

Mailing address

PO Box 102
Waverly, IA 50677-0102
Phone (319) 559-1065

Other practice location 1

800 11th St
Charles City, IA 50616-3468
Phone (319) 559-1065

Other practice location 2

2307 Falls Ave Ste 5
Waterloo, IA 50701-5700
Phone (319) 559-1065

Other identifiers 1

IdentifierTypeStateIssuer
1174833537MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210524001838 IA Part B Supplier - Clinic/Group Practice 2264831239 Receives reassigned benefits from 2 practitioners
Practice locations: Waterloo, IA; Waverly, IA; Charles City, IA

National Provider Directory

National Provider Directory

Locations

302 N Grand Ave
Charles City, IA 50616
Phone (319) 240-9033

2307 Falls Ave
Ste 5
Waterloo, IA 50701
Phone (319) 559-1065

506 E Bremer Ave
Waverly, IA 50677
Phone (319) 224-5397

Practitioners 11

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": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1225514540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506770102",
            "telephone_number": "319-559-1065",
            "fax_number": "319-575-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E BREMER AVE",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "50677",
            "telephone_number": "319-559-1065",
            "fax_number": "319-575-6065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 11th St",
            "address_purpose": "LOCATION",
            "city": "Charles City",
            "state": "IA",
            "postal_code": "506163468",
            "country_code": "US",
            "telephone_number": "319-559-1065",
            "fax_number": "319-575-6065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2307 Falls Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507015700",
            "country_code": "US",
            "telephone_number": "319-559-1065",
            "fax_number": "319-575-6065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH IOWA COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "HJELMELAND",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CLINICIAN",
        "authorized_official_telephone_number": "319-559-1065",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISW IADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174833537",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; 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.