Organization Active NPI

Grief Counseling and Therapeutic Services, LLC

  • Clinical Social Worker
  • Bettendorf, IA
National Provider Identifier
1467065235
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GRIEF COUNSELING AND THERAPEUTIC SERVICES, LLC
Practice address
2435 East Kimberly Rd
Suite 300 South
Bettendorf, IA 52722-3509
Phone
(319) 750-8525
NPI assigned
Aug 31, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Julie Bockenstedt, PHD, LCSWNPI 1285931915
Title
Therapist
Phone
(319) 750-8525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2435 East Kimberly Rd
Suite 300 South
Bettendorf, IA 52722-3509

Mailing address

2435 East Kimberly Rd
Suite 300 South
Bettendorf, IA 52722
Phone (319) 750-8525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210104000654 IA Part B Supplier - Clinic/Group Practice 8729491139 Receives reassigned benefits from 1 practitioner
Practice locations: Bettendorf, IA

National Provider Directory

National Provider Directory

Locations

2435 Kimberly Rd
Ste 300S
Bettendorf, IA 52722
Phone (319) 750-8525

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1467065235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 EAST KIMBERLY RD",
            "address_2": "SUITE 300 SOUTH",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "319-750-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 EAST KIMBERLY RD",
            "address_2": "SUITE 300 SOUTH",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223509",
            "telephone_number": "319-750-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIEF COUNSELING AND THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "BOCKENSTEDT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "319-750-8525",
        "authorized_official_credential": "PHD, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.