Active NPI
Jiaben Su
- Mental Health Counselor
- Coralville, IA
National Provider Identifier
1427967967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 140243
- Practice address
- 1150 5TH St Ste 290
Coralville, IA 52241-2933 - Phone
- (319) 804-9312
- Fax
- (319) 449-3845
- NPI assigned
- Sep 2, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 140243 | IA | Primary |
Addresses
Primary practice location
1150 5TH St Ste 290
Coralville, IA 52241-2933
Mailing address
1150 5TH St Ste 290
Coralville, IA 52241-2933
Phone (319) 804-9312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1427967967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 5TH ST STE 290",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522412933",
"telephone_number": "319-804-9312",
"fax_number": "319-449-3845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 5TH ST STE 290",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522412933",
"telephone_number": "319-804-9312",
"fax_number": "319-449-3845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SU",
"first_name": "JIABEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-02",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "140243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.