Jacquelyn Sue Marcum, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001619 Issued in IA

Practice address

427 E Kanesville Blvd
Council Bluffs, IA 51503-9079

Phone

(712) 256-9660

Fax

(712) 256-9661

NPI assigned

Aug 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Therapy ResourcesGroup PAC ID 0244573699, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Integrated Therapy Resources

  • Mental Health Counselor
  • Council Bluffs, IA
  • NPI 1457829913
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1376179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376179200000",
    "number": "1407289713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 GROVER AVE",
            "city": "MISSOURI VALLEY",
            "state": "IA",
            "postal_code": "515557020",
            "telephone_number": "402-980-8266",
            "fax_number": "712-256-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 E KANESVILLE BLVD",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039079",
            "telephone_number": "712-256-9660",
            "fax_number": "712-256-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "JACQUELYN",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-11",
        "last_updated": "2013-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley M Manhart, MSN, CDE
• Gerson Gibran Manriquez Martinez, MD
• James K Mantone, MD
• Duane Allen Manzer, ATC
• Isam Elias Marar, M.D.
• Kristin Elizabeth Markel, AGACNP-BC
• Tara Jean Marsh
• David S Marshall, DMD
• John W Marshall, M.D.
• Melissa Spencer Marshall, ARNP

• Mental Health Counselor in Council Bluffs, IA
• Providers in Council Bluffs, 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 Aug 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.