Active NPI
Lance Jeremy Stumbo, LMFT
- Mental Health Counselor
- Perry, IA
National Provider Identifier
1346544053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 000329
- Practice address
- 600 1St Ave
Perry, IA 50220-1803 - Phone
- (515) 232-2640
- Fax
- (515) 233-2129
- NPI assigned
- Jan 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 000329 | IA | Primary |
Addresses
Primary practice location
600 1St Ave
Perry, IA 50220-1803
Mailing address
3125 Douglas Ave Ste 100
Des Moines, IA 50310-5310
Phone (515) 232-2640
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000329 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1346544053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 DOUGLAS AVE STE 100",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503105310",
"telephone_number": "515-232-2640",
"fax_number": "515-233-2129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 1ST AVE",
"city": "PERRY",
"state": "IA",
"postal_code": "502201803",
"telephone_number": "515-232-2640",
"fax_number": "515-233-2129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUMBO",
"first_name": "LANCE",
"middle_name": "JEREMY",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-10",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "000329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perry, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.