Active NPI
Augustine Thabo Shija
- Mental Health Counselor
- Council Bluffs, IA
National Provider Identifier
1356294367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 136048
- Practice address
- 1720 N 16TH St Ste K
Council Bluffs, IA 51501-0109 - Phone
- (712) 256-4420
- NPI assigned
- Feb 18, 2026
- 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 | 136048 | IA | Primary |
Addresses
Primary practice location
1720 N 16TH St Ste K
Council Bluffs, IA 51501-0109
Mailing address
110 S 35TH St
Council Bluffs, IA 51501-3286
Phone (319) 595-3151
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 |
|---|---|---|---|
| 136048 | IA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Connections, Inc | Single Specialty | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771372800000",
"number": "1356294367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S 35TH ST",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515013286",
"telephone_number": "319-595-3151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 N 16TH ST STE K",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515010109",
"telephone_number": "712-256-4420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIJA",
"first_name": "AUGUSTINE",
"middle_name": "THABO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-02-18",
"last_updated": "2026-02-18",
"certification_date": "2026-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "136048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.