Jonathan Backstrom, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

JONATHAN BACKSTROM, LLC

Practice address

2625 W 36TH St
Davenport, IA 52806-5224

Phone

(563) 650-5863

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Jon Backstrom, LMHCNPI 1588040190

Title

Therapist

Phone

(563) 650-5863

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon Backstrom, M.S. ED., LMHC

  • Mental Health Counselor
  • Davenport, IA
  • NPI 1588040190
  NPD Authorized official

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1356932073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W 36TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065224",
            "telephone_number": "563-650-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W 36TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065224",
            "telephone_number": "563-650-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN BACKSTROM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "BACKSTROM",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "563-650-5863",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Johnson, LMT
• Toshia Johnson, MSED, LMHC
• Trudi H Johnson, APRN, CNP
• Tyler Johnson, D.C.
• Jessica Johnstone, D.C.
• Andrea Lynn Jones, M.D.
• Ann M Jones, MA
• Hailey Jones, PTA
• Laura Lynn Jones
• Lisa Mae Jones, FNP

• Mental Health Counselor in Davenport, IA
• Providers in Davenport, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.