Organization Active NPI

Prairie River Counseling PLLC

  • Mental Health Counselor
  • Sioux City, IA
National Provider Identifier
1477324044
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PRAIRIE RIVER COUNSELING PLLC
Practice address
33148 K22
Sioux City, IA 51108-8630
Phone
(712) 301-7411
NPI assigned
Jan 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Rebecca Simoni-Ryan, LMHCNPI 1295346815
Title
Manager/Therapist
Phone
(712) 301-7411

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

33148 K22
Sioux City, IA 51108-8630

Mailing address

828 Romans Rd
Sioux City, IA 51106-9671

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240214004073 IA Part B Supplier - Clinic/Group Practice 5890139125 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

33148 K22
Sioux City, IA 51108
Phone (712) 301-7411

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": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1477324044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 ROMANS RD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511069671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33148 K22",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511088630",
            "telephone_number": "712-301-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE RIVER COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-14",
        "status": "A",
        "authorized_official_last_name": "SIMONI-RYAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "MANAGER/THERAPIST",
        "authorized_official_telephone_number": "712-301-7411",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.