Wellful Psychiatry, PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

WELLFUL PSYCHIATRY, PLLC

Practice address

520 West Main Street
Waukon, IA 52172

Phone

(563) 217-6488

Fax

(800) 507-8981

NPI assigned

Oct 3, 2023

Last updated

Apr 17, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Malory L LarsonNPI 1255951166

Title

Arnp, Pmhnp-BC

Phone

(563) 217-6488

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Practitioners 3

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.

• Malory L Larson, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Cresco, IA
  • NPI 1255951166
  Medicare reassignment NPD Authorized official
• Shannon Christine Breitenstein, LMHC

  • Mental Health Counselor
  • Cedar Rapids, IA
  • NPI 1215534359
  NPD
• Lisbeth Ann Peirce, LMHC

  • Professional Counselor
  • Decorah, IA
  • NPI 1467103812
  NPD

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1346020740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 345",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521720345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 WEST MAIN STREET",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "52172",
            "telephone_number": "563-217-6488",
            "fax_number": "800-507-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLFUL PSYCHIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "MALORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ARNP, PMHNP-BC",
        "authorized_official_telephone_number": "563-217-6488"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Waters, PTA
• Waukon Family Chiropractic
• Waukon Ia Skilled Nursing Facility, LLC (Southcrest Manor Operator)
• Waukon Ia Skilled Nursing Facility, LLC
• Waukon Ia Skilled Nursing Facility, LLC
• Sara White, PTA
• Worth Living Inc. (Waukon Living Center)
• Anastasia Zink, OTA

• Psychiatric/Mental Health Nurse Practitioner in Waukon, IA
• Providers in Waukon, IA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.