Individual provider Active NPI

Robyn L Rodenburgh, LMHC

  • Mental Health Counselor
  • Waterloo, IA
National Provider Identifier
1437395688
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00929 Issued in IA
Practice address
142 Brookeridge Dr
Waterloo, IA 50702-5702
Phone
(319) 231-5871
Fax
(888) 981-5029
NPI assigned
Dec 17, 2008
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 00929 IA Primary

Addresses

Primary practice location

142 Brookeridge Dr
Waterloo, IA 50702-5702

Mailing address

104 Brookeridge Dr # 186
Waterloo, IA 50702-5702
Phone (319) 231-5871

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
I20240531003623 IA Practitioner - Mental Health Counselor 0244672533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

142 Brookeridge Dr
Waterloo, IA 50702-5702
Phone (319) 231-5871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00929IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Robyn Rodenburgh, Inc. Mental Health CurrentSince Feb 27, 2024 Accepting new patients
Kerry Sullivan Counseling PLLC Mental Health CurrentSince Nov 19, 2023 Accepting new patients

Locations

104 Brookeridge Dr
Waterloo, IA 50702

142 Brookeridge Dr
Ste 186
Waterloo, IA 50702

142 Brookeridge Dr
Waterloo, IA 50702
Phone (319) 231-5871

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": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1437395688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BROOKERIDGE DR # 186",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025702",
            "telephone_number": "319-231-5871",
            "fax_number": "888-981-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 BROOKERIDGE DR",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025702",
            "telephone_number": "319-231-5871",
            "fax_number": "888-981-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODENBURGH",
        "first_name": "ROBYN",
        "middle_name": "L",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.