NPIMap

Organization Active NPI

SRB Counseling, LLC

  • Clinical Social Worker
  • Dubuque, IA
National Provider Identifier
1265070197
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SRB COUNSELING, LLC
Practice address
799 Main St Ste 350
Dubuque, IA 52001-6825
Phone
(563) 557-6870
Fax
(563) 557-6870
NPI assigned
Dec 10, 2019
Last updated
Dec 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Authorized official

Name
Stacey Richard-Baal, LISC, LCSWNPI 1720443377
Title
Owner, Therapist
Phone
(563) 557-6870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

799 Main St Ste 350
Dubuque, IA 52001-6825

Mailing address

3055 Indiana CT
Dubuque, IA 52001-5482
Phone (563) 581-2064

National Provider Directory

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1265070197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 INDIANA CT",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520015482",
            "telephone_number": "563-581-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 MAIN ST STE 350",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016825",
            "telephone_number": "563-557-6870",
            "fax_number": "563-557-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRB COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-10",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "RICHARD-BAAL",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OWNER, THERAPIST",
        "authorized_official_telephone_number": "563-557-6870",
        "authorized_official_credential": "LISC, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.