Individual provider Active NPI

Dawn Marie Clements

  • Mental Health Counselor
  • Milford, IA
National Provider Identifier
1376159665
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
096572 Issued in IA
Practice address
910 10TH St
Milford, IA 51351-1530
Phone
(712) 338-6200
NPI assigned
Sep 22, 2020
Last updated
Sep 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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 096572 IA Primary

Addresses

Primary practice location

910 10TH St
Milford, IA 51351-1530

Mailing address

1527 West St
Grinnell, IA 50112-1444
Phone (641) 990-3716

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
I20231219002678 IA Practitioner - Mental Health Counselor 4688024557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elevate Therapy and Assessment, PLLCGroup PAC ID 6709213507, 9 clinicians

Practice addresses (Care Compare)

2102 N Ave
Elevate Therapy and Assessment
Milford, IA 51351-1249
Phone (712) 338-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
096572IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Therapy & Assessment, PLLC CurrentSince Nov 15, 2023 Accepting new patients
Champion State of Mind PLLC Mental Health PastSince Sep 27, 2020 Accepting new patients

Locations

910 10th St
Milford, IA 51351
Phone (712) 338-6200

Organizations & group practices 3

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": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1376159665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 WEST ST",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121444",
            "telephone_number": "641-990-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 10TH ST",
            "city": "MILFORD",
            "state": "IA",
            "postal_code": "513511530",
            "telephone_number": "712-338-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTS",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "096572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, IA

Sources for this page

Verify at the official NPI Registry.