Individual provider Active NPI

Marcia Wulfekuhle, IADC LBSW

  • Addiction (Substance Use Disorder) Counselor
  • Waterloo, IA
National Provider Identifier
1275955304
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
85069 Issued in IA
Practice address
3362 University Ave
Waterloo, IA 50701-2006
Phone
(319) 235-6571
Fax
(319) 235-6028
NPI assigned
Jan 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 85069 IA Primary
Social Worker 104100000X 01281 IA

Addresses

Primary practice location

3362 University Ave
Waterloo, IA 50701-2006

Mailing address

3362 University Ave
Waterloo, IA 50701-2006
Phone (319) 235-6571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
85069IAMDAddiction (Substance Use Disorder) Counselor
01281IAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389139200000",
    "number": "1275955304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3362 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012006",
            "telephone_number": "319-235-6571",
            "fax_number": "319-235-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3362 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012006",
            "telephone_number": "319-235-6571",
            "fax_number": "319-235-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULFEKUHLE",
        "first_name": "MARCIA",
        "credential": "IADC    LBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "85069",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "01281",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; 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.