Organization Active NPI

Family Wellbeing Associates, LLC

  • Clinical Social Worker
  • North Liberty, IA
National Provider Identifier
1386125318
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FAMILY WELLBEING ASSOCIATES, LLC
Practice address
723 Pacha Pkwy
North Liberty, IA 52317-4796
Phone
(319) 775-0074
Fax
(319) 774-6775
NPI assigned
Aug 28, 2018
Last updated
Feb 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Jennifer L TheurerNPI 1710247879
Title
Owner
Phone
(319) 775-0074

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

723 Pacha Pkwy
North Liberty, IA 52317-4796

Mailing address

27 Kearney CT
Iowa City, IA 52246-2799
Phone (319) 551-2498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181226002103 IA Part B Supplier - Clinic/Group Practice 4385989102 Receives reassigned benefits from 2 practitioners
Practice locations: North Liberty, IA; Tiffin, IA

National Provider Directory

National Provider Directory

Locations

723 Pacha Pkwy
North Liberty, IA 52317
Phone (319) 775-0074

1 Quail Creek Cir
North Liberty, IA 52317
Phone (319) 775-0074

1140 Tall Grass Ave
Tiffin, IA 52340
Phone (319) 775-0074

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1386125318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 KEARNEY CT",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462799",
            "telephone_number": "319-551-2498",
            "fax_number": "319-774-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 PACHA PKWY",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174796",
            "telephone_number": "319-775-0074",
            "fax_number": "319-774-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLBEING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "THEURER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-775-0074"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.