Individual provider Active NPI

Mary E Meyer, PHD, LMFT, CSAT

  • Clinical Social Worker
  • Ankeny, IA
National Provider Identifier
1417180902
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1605 N Ankeny Blvd Ste 210
Ankeny, IA 50023-4163
Phone
(515) 705-0174
Fax
(515) 310-4003
NPI assigned
Aug 31, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Marriage & Family Therapist 106H00000X 166.001000 IL
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1605 N Ankeny Blvd Ste 210
Ankeny, IA 50023-4163

Mailing address

1605 N Ankeny Blvd Ste 210
Ankeny, IA 50023-4163
Phone (515) 705-0174

Other practice location 1

3200 Ingersoll Ave Ste E
Des Moines, IA 50312-3917
Phone (515) 705-0174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
166.001000ILMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Full Heart Family Therapy and Renewal Center LLC Clinical CurrentSince Feb 4, 2019 Accepting new patients

Locations

1605 N Ankeny Blvd
Ste 210
Ankeny, IA 50023
Phone (515) 704-0174

602 SE Delaware Ave
Ankeny, IA 50021
Phone (515) 705-0174

Organizations & group practices 1

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": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1417180902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 N ANKENY BLVD STE 210",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234163",
            "telephone_number": "515-705-0174",
            "fax_number": "515-310-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 N ANKENY BLVD STE 210",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500234163",
            "telephone_number": "515-705-0174",
            "fax_number": "515-310-4003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Ingersoll Ave Ste E",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503123917",
            "country_code": "US",
            "telephone_number": "515-705-0174",
            "fax_number": "515-310-4003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYER",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD, LMFT, CSAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001000",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.