NPIMap

Organization Active NPI

Ivory Lotus Therapy

  • Mental Health Counselor
  • Waukee, IA
National Provider Identifier
1487370433
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
IVORY LOTUS THERAPY
Practice address
225 NE Dartmoor Dr Ste 300
Waukee, IA 50263-9665
Phone
(515) 650-2454
NPI assigned
Oct 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Jasmina Pajazetovic, LMHC, NCCNPI 1740888312
Title
Clinical Therapist
Phone
(515) 650-2454

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

225 NE Dartmoor Dr Ste 300
Waukee, IA 50263-9665

Mailing address

225 NE Dartmoor Dr Ste 300
Waukee, IA 50263-9665
Phone (515) 650-2454

National Provider Directory

National Provider Directory

Locations

225 NE Dartmoor Dr
Ste 300
Waukee, IA 50263
Phone (515) 447-6539

Practitioners & affiliated clinicians

Practitioners 2

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": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1487370433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NE DARTMOOR DR STE 300",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502639665",
            "telephone_number": "515-650-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NE DARTMOOR DR STE 300",
            "city": "WAUKEE",
            "state": "IA",
            "postal_code": "502639665",
            "telephone_number": "515-650-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVORY LOTUS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "PAJAZETOVIC",
        "authorized_official_first_name": "JASMINA",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "515-650-2454",
        "authorized_official_credential": "LMHC, NCC"
    },
    "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 Waukee, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.