Individual provider Active NPI

Michael Fink, LMHC

  • Professional Counselor
  • Iowa City, IA
National Provider Identifier
1407429434
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
108822 Issued in IA
Practice address
438 Southgate Ave
Iowa City, IA 52240-4425
Phone
(319) 351-4357
NPI assigned
Jul 19, 2021
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 108822 IA
Addiction (Substance Use Disorder) Counselor 101YA0400X 108822 IA
Mental Health Counselor 101YM0800X 108822 IA
Professional Counselor 101YP2500X 108822 IA Primary

Addresses

Primary practice location

438 Southgate Ave
Iowa City, IA 52240-4425

Mailing address

430 Southgate Ave
Iowa City, IA 52240-4425

Other identifiers 1

IdentifierTypeStateIssuer
108822MedicaidIA

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
I20240622000486 IA Practitioner - Mental Health Counselor 7719420405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alli Center LLCGroup PAC ID 9638439128, 12 clinicians

Practice addresses (Care Compare)

1150 5TH St
Suite 270
Coralville, IA 52241-2933
Phone (319) 804-9312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108822IAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alli Center LLC Mental Health CurrentSince Jun 14, 2024 Accepting new patients
Prelude Behavioral Services PastSince Jul 25, 2021 Accepting new patients

Locations

1150 5th St
Ste 270
Iowa City, IA 52241
Phone (319) 804-9312

Organizations & group practices 2

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1407429434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 SOUTHGATE AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522404425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 SOUTHGATE AVE",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522404425",
            "telephone_number": "319-351-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "MICHAEL",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IA",
            "license": "108822",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "108822",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "108822",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IA",
            "license": "108822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108822",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.