Individual provider Active NPI

Susan Renee Tridle

  • Mental Health Counselor
  • Des Moines, IA
National Provider Identifier
1285301176
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3805 Lower Beaver Rd
Des Moines, IA 50310-4708
Phone
(515) 279-0111
NPI assigned
Aug 27, 2021
Last updated
Aug 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3805 Lower Beaver Rd
Des Moines, IA 50310-4708

Mailing address

1844 310TH St
Orient, IA 50858-8017
Phone (641) 745-0002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218003568 IA Practitioner - Mental Health Counselor 2961851852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Recovery Centers IncGroup PAC ID 2466599634, 8 clinicians

Practice addresses (Care Compare)

210 Russell St
Suite a
Creston, IA 50801-3149
Phone (815) 391-1000

3200 W 4TH St
Sioux City, IA 51103-3204
Phone (712) 234-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Behavioral Health Center CurrentSince Aug 3, 2025 Accepting new patients
Choices Therapy Services, LLC CurrentSince Aug 29, 2021 Accepting new patients
Jackson Recovery Centers, Inc. CurrentSince Mar 9, 2026 Accepting new patients
Choices Therapy Services, LLC Mental Health PastSince Aug 29, 2021 Accepting new patients

Locations

1003 Cottonwood Rd
Creston, IA 50801
Phone (641) 782-8457

210 Russell St
Creston, IA 50801
Phone (641) 782-8457

3805 Lower Beaver Rd
Des Moines, IA 50310
Phone (515) 279-0111

405 E McLane St
Osceola, IA 50213
Phone (641) 342-4888

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1285301176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 310TH ST",
            "city": "ORIENT",
            "state": "IA",
            "postal_code": "508588017",
            "telephone_number": "641-745-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 LOWER BEAVER RD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104708",
            "telephone_number": "515-279-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIDLE",
        "first_name": "SUSAN",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.