Individual provider Active NPI

Whitney Marie Anderson, LMHC

  • Mental Health Counselor
  • Waterloo, IA
National Provider Identifier
1346908993
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
108494 Issued in IA
Practice address
531 Commercial St Ste 202
Waterloo, IA 50701-5497
Phone
(515) 290-2426
Fax
(515) 462-0633
NPI assigned
Dec 1, 2021
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 108494 IA Primary

Addresses

Primary practice location

531 Commercial St Ste 202
Waterloo, IA 50701-5497

Mailing address

1058 Evergreen Ave
Waterloo, IA 50701-2223

Other practice location 1

3839 Merle Hay Rd Ste 227
Des Moines, IA 50310-1312
Phone (515) 669-8111

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
I20240926000688 IA Practitioner - Mental Health Counselor 3779024005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Law

State licenses

LicenseStateTypeSpecialty
108494IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Therapy and Counseling Services Mental Health CurrentSince Jul 20, 2024 Accepting new patients

Locations

3839 Merle Hay Rd
Ste 227
Des Moines, IA 50310
Phone (515) 669-8111

Organizations & group practices 1

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": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1346908993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 EVERGREEN AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 COMMERCIAL ST STE 202",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015497",
            "telephone_number": "515-290-2426",
            "fax_number": "515-462-0633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3839 Merle Hay Rd Ste 227",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503101312",
            "country_code": "US",
            "telephone_number": "515-669-8111",
            "fax_number": "515-462-0633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "WHITNEY",
        "middle_name": "MARIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "108494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.